Since implementing MedEvolve Patient Financial Clearance Workflow,
- COB denials are down 75%
- Patient payments are up 15%
- Point of service collections are up 300% from $12 to $36
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. Recently, 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.”
"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."
Outcomes
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: a decrease in:
- COB denials are down 75%
- Patient payments are up 15%
- Point of service collections are up 300% from $12 to $36
Hammack said the impact on workflow efficiency and the patient experience is significant.
"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."
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