RP Sanjiv Goenka Group

Hospital doubles collections with zero-touch patient financial clearance

The challenge: Complex, cumbersome process combined with crushing time constraints

Financial clearance is supposed to be user-friendly for patients and effective for providers. But often, the process is complex and cumbersome and hampers care delivery. That was the case at a large, Atlanta-based integrated academic healthcare system – for its 11 hospitals and more than 250 provider locations.

Employees only have a short window of time prior to the scheduled service to gather the information they need. Yet, the client’s manual system required multiple phone calls to patients to verify their demographic and insurance data and discuss the patient financial responsibility. Staff struggled to get patients on the phone or to respond to their messages. As a result, 95% of scheduled patients were not pre-registered. The provider only collected two percent of Net Provider Revenue at the pre-service stage.

The solution: AI-powered portal propels patient financial clearance

The Provider selected our Pre-Service solution to integrate key functions into a unified workflow and create  a patient-friendly registration and financial experience.  We also deployed our digital self-service portal enabling a 360-degree view of all customer interactions across channels.

Streamlining the financial clearance process was crucial to not only the provider’s bottom line, but also the patient experience. As a first step, Firstsource experts mapped out the financial clearance process and identified data repositories within the client system. Next, we developed a proof of concept (POC) for an automated solution that would access and extract core patient data and present the information to payers and patients for verification. Once the POC was approved by the client’s leadership team, Firstsource designed and deployed a zero-touch solution, underpinned by our digital self-service tool.

The results: Automation amps up collections considerably

Firstsource’s automated approach yielded the Provider striking results: collections improved by 240%. Enhancing data integrity led to reduced patient cancellations and no-shows. Patient wait-time upon arrival at the care facility was reduced, which also mitigated the need for face-to-face contact during the health crisis.

Business impact

2X

improvement in collections


Reduced

patient cancellations and no-shows


Enabled

patient self-service


Automated

workflows for patient pre-screening and eligibility


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