RP Sanjiv Goenka Group

Montefiore St.Lukes Cornwall (MSLC), a not-for-profit hospital elevates patient financial experience while improving POS collections by 125%

Unifying the patient financial experience

Montefiore St.Lukes Cornwall Hospital (MSLC), a 250-bed not-for-profit inner city hospital, treats 270K patients every year and is ranked amongst the top 5% of America’s 250 best hospitals by Healthgrades. The hospital’s payer mix comprises a high mix of government and self-pay patients, making it imperative to improve collection of patient financial responsibility – more so in the post-pandemic era where patients are increasingly accountable for a larger portion of their medical bills.

As patients’ out-of-pocket healthcare expenses skyrocket, MSLC wanted to take a comprehensive approach – one that focuses on enhancing the patient financial experience to improve revenue and collections. The hospital embraced a comprehensive patient experience initiative and embarked on a journey to restructure its patient access model. It partnered with Firstsource to identify and implement the right-fit strategies and solutions.

Tackling wide-ranging challenges

MSLC’s patient registration and financial services varied greatly across its facilities and service lines. The inconsistencies significantly impacted the patient financial experience as well as its bottom line:

  • Poor cash collection and long collection cycles
  • Lack of patient experience benchmark data for key indicators
  • Lack of Point-of-service (POS) collection goals for individual staff and groups
  • Inaccurate or missing bill estimates
  • Registration data collection prone to errors due to highly manual registration processes
  • Low “clean claims” rate
  • Payment delays

Additional challenges included prolonged patient wait-times, high no-show and cancellation rates across various clinical departments, and low staff productivity.

Business Challenge

  • Inconsistent registration and financial services, impacting the patient financial experience and the hospital’s bottom line
  • Long patient wait-times and high no-show and cancellation rates
  • Low staff productivity

Transforming pre-access

MSLC’s patient access and revenue cycle leaders sought buy-in from its top leadership and involved employees acrossr clinical financial, IT, marketing teams in the planning and implementation. Firstsource collaborated with MSLC’s patient access, revenue cycle and leadership teams to design and implement a patient-centric pre-access model that engages patients ahead of receiving healthcare services.

A patient-friendly model

  • Firstsource leveraged its proprietary IntelliAdvisor solution to centralize scheduling, streamline workflows across departments, develop custom financial guidance and planning, and expand staff roles to cover pre-registration and financial services responsibilities.2
  • To drive overall patient satisfaction and hospital performance, the model design included optimized and customizable cross-functional workflows, comprising six steps, to financially clear patients before their arrival at the hospital.
  • Using patient access technology, the Firstsource team integrated traditionally disconnected pillars of work, including order management, scheduling, prior authorization, pre-registration, payment collection, and patient navigation.
  • Firstsource experts then provided training and development support – educating referring physicians, conducting workshops for the registration staff and coaching staff, benchmarking performance and providing feedback to managers on staff strengths and challenges.
  • To ensure the adoption of pre-access procedures and staff accountability, managers and department leaders were equipped to capture and monitor productivity reports that measure individual and team performance.

Streamlined workflows

The pre-access workflow processes all patients before their visit by segmenting them into three groups – no-stop, quick-stop and full-stop status – to reduce lobby wait times, appointment cancellations, and swiftly and effectively guide patients to their clinical destination.

Beating expectations

The patient-centric pre-access model continues to improve operational patient flow and reduce processing times for MSLC by empowering staff and patients with accurate, timely information that drives payment even before services are rendered. The solution has created an environment where the patient’s clinical and financial experience work in sync to provide a positive patient healthcare journey from beginning to end. The result: MSLC’s numbers continue to see ongoing improvements even today

Solution Synopsis

  • Leveraged patient-centric technology to improve patient experience, reduce stress of care, and accelerate collections
  • Implemented customized and integrated workflows to maximize the benefits of the implementation
  • Provided ongoing training and development along with onsite expertise to help build high performance patient access teams


  • Improved operational patient flow
  • Reduced processing times
  • Positive patient healthcare journey

Business impact


personalized bill estimate accuracy


increase in POS collections, six months from go-live


reduction of in-person registration encounter time


reduction in no-show and cancellation rates

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