Obtain a Positive Patient Finance Experience Through a Front-End Approach to Revenue Cycle

As the new vice president of revenue cycle at Mosaic Life Care in Northwest Missouri, Deborah Vancleave was to create a best-in-class revenue cycle. In years past, Mosaic struggled with eligibility, manual calculation of patient liability, lack of consistent prior authorizations, and adequate and timely training of patient access representatives. These struggles resulted in significant final write-offs due to access errors – approximately $4.5 million a year, about 40% of total denials.

Vancleave knew that the revenue cycle is the first and last point of contact with the patient. Great quality of care has potential to get lost if patients have a bad experience prior to or even after service. That’s why her focus was on the patient financial experience and frontline employees.

Here’s a list of four things that organizations can adopt to better manage their revenue cycle at the front-end:

  1. Integrity at the Front-End: For decades, lack of integrity in data plagued the business of health care. Controlling the quality of registration and billing information on the front end affects billing outcomes and causes unnecessary grief to patients over unresolved balances.
  2. Invest in Adequate Technology: Systems that can’t monitor quality, self-assign training, identify presumptive charity, return detailed eligibility, and estimate patient out of pocket costs, are not adequate. Newer intelligent applications capable of predictive analytics that are built to learn and adapt are now required. Mosaic integrated the AccuReg full suite of front-end automation tools into the Cerner Millennium electronic medical record system.
  3. Implementation and Accountability: Focus on basic insurance eligibility, quality assurance, and training. Quality assurance is a critical missing piece for many. The new technology enabled Mosaic to create an edit-based workflow to track, monitor and manage registration quality and point of service collections, including identification of any missed collection opportunities. The technology created an effective method for accountability via reporting and dashboards. Additionally, registration accuracy is tied to goals and performance metrics.
  4. Measurement and Return on Investment: Included patient identification, financial screening, presumptive charity and authorization management. In just eight months Mosaic increased registration quality to 96%- 98% accuracy rate. Mosaic significantly reduced patient access final write-offs by more than 50% which now measures about 1.6%, down from 3.8% overall. Bad debt has decreased by about 30%.

Find out how Mosaic cut bad debt write offs in half – click here to read the Mosaic Life Care Case Study.

Read more about Vancleave’s experiences in A Front-End Preventive Approach to the Revenue Cycle Contributes to a Positive Patient Financial Experience.