CASE STUDY

South County Urological improves financial clearance outcomes with Effective Intelligence

COB denials are down and patient payments are up at this physician practice

South County Urological has realized positive bottom-line outcomes since deploying the financial clearance solution on numerous fronts. Proactive oversight of pre-registration activities has resulted in:

"Since we implemented the financial clearance platform, we’ve completely changed the way that we receive patients. We do everything two to three days prior to the patient coming in, so when a patient arrives at the office, all preregistration activity is complete. Not only does this improve our financial outlook as a practice, but it allows us to focus on patients’ care when they are in the office."

About South County Urological

 South County Urological has served the greater St. Louis region of Missouri for more than 40 years. The practice has three board-certified urologists recognized for their expertise and innovative care. The organization offers a range of treatment options including new, minimally invasive procedures with quicker recovery times such as robotic surgery. The organization serves most patients’ needs through its main practice office or medical building that includes a laboratory and surgery center. 

A long-time client, South County Urological has used MedEvolve’s practice management software since the early 2000s. The practice expanded upon these offerings by implementing MedEvolve Financial Clearance Workflow Automation platform. 

Challenge

 Like most physician practices operating in today’s lean climate, South County Urological must maximize revenue capture to ensure a stable bottom line. High deductible health plans are increasingly shifting collections from the payer to the consumer, which means providers must find better ways to collect patient balances. In tandem with this trend, patients want greater transparency into their benefits and costs upfront along with easy payment options. 

"Our relationship with MedEvolve has always been a strong partnership characterized by open communication. We appreciate that they have listened to our needs over the years and consistently prioritize product innovation to improve processes and workflows."

South County Urological faced multiple challenges with their financial clearance—or pre-registration—process, including accurate capture of demographic information and collection of patient balances prior to an encounter. Manual, burdensome efforts to track and follow-up with patients prior to scheduled appointments left many items overlooked such as changes to insurance information and unresolved balances. 

Hammack noted that these tasks would too often fall to front-desk staff when a patient arrived for their appointment —a scenario that was not optimal for the patient experience. She also noted that lack of transparency into staff workflows made it difficult to pinpoint where issues originated and identify process improvement and training opportunities.

Solutions

South County Urological implemented MedEvolve’s AI-powered Financial Clearance Workflow Automation platform to streamline financial clearance processes and help staff work smarter. The solution leverages visual cues and natural workflow automation to ensure resources are used effectively and financial data is transparent and accurate, while also alerting responsible team members to any needed follow up or action. The platform facilitates work, actions and information required before the patient walks through the door, including: 

  • Insurance and co-insurance verification 
  • Insurance benefit coverage confirmation 
  • Patient liability estimation 
  • Projected and prior balance collections 
  • Demographic information validation 
  • Authorizations
     

Eliminating risks up front helps to minimize the chance the practice will miss out on revenue later from denials, rejections and write-offs and ensures they get paid quickly and accurately. The solution allows staff at South County Urological to know where each patient is in the financial clearance process, in real-time, and what needs to happen next. The staff feel empowered because they know what they need to work on from the time they get started in the morning and guesswork has been eliminated. 

Increased transparency also means that Hammack can make sure the right staff members are allocated to priority tasks on a daily basis and accountable to productivity expectations and goals. Patients appreciate the new procedures, which streamline the amount of time they spend at the front desk, help improve communication about payment options and eliminate billing surprises on the day of an appointment. 

Hammack pointed out that the solution proved especially beneficial when COVID-19 hit by enabling a remote workforce with built-in tools such as messaging and task management. “During a very challenging time, we had the flexibility to prioritize staff and patient safety, while still taking care of the day-to-day business of running a practice,” she said. “The ability to quickly mobilize a virtual workforce proved very advantageous.” 

"Our patient flow is so much smoother now because registration activity is no longer running into appointment times and creating bottlenecks. Patients are really excited to get that out of the way before they even come in. It creates more of a concierge experience for the patient when they enter the practice. Instead of dealing with all the tedious checks and balances needed to ensure business operations run smoothly, we can focus on making the patient feel welcome and at ease."

Run your Front and Back Office with Effective Intelligence

Effective Intelligence cloud-based technology bolts onto your current PM/EMR and includes workforce automation modules and intelligent analytics designed to ensure RCM staff are working effectively and generating the expected revenue.

Review and assess your practice’s financial status in 5 min or less and know exact where you are losing money and why. Measure the work effort of every revenue cycle employee, incentivize and retain your top performers, and help employees that need improvement.

You can prevent most common denials, rejections and write-offs during the scheduling and pre-registration process in advance of the appointment. Configure checkpoints and use central task management to quickly clear patients and keep your front office staffing needs at a minimum.

As team members log in to the web-based application and record each “touch” of a claim,  outcome, and next task, key data points are recorded like who completed the task and when, outcome, task notes, internal / external messages sent, collection success and other data points that feed into our real-time analytics.

Reduce RCM labor dependency with workflow automation, task management, & real-time analytics to increase margin.

Outsource your medical billing to us with over 20 years of revenue cycle experience incorporating Effective Intelligence in house.

Improve patient collection rates with account resolution services: call center, mobile engagement, payment portal & counseling.

Increase productivity and visibility into front & back office processes while keeping your staff focused.​