Improving US Hospital Patient Registration Processes and Bottom Line Financial Results

By DerrikKyle on February 11, 2010, 7:47 pm

According to the American Hospital Association sixty percent of hospitals in the US lose money providing patient care; this really is a shocking statistic especially in this time of economic downturn and highlights the inefficiencies in the administration processes going on in US Hospitals.
If you have ever been treated at a hospital in the US you will probably been exposed to some of the administrative complexity which results in the losses I have described. To be precise, Healthcare Providers lose $60bn per year because of administrative errors. To put this into perspective this equates to the 2007 cost of providing universal healthcare through the British National Health Service to 25 million people in Britain.
Problems begin right at the registration point. It always amazes me just how much information must be gathered and processes initiated at patient registration time; such as insurance plan code identification, insurance eligibility verification, demographic checking, credit risk assessment, charity availability, pricing estimation and much more. Patient registration not only involves the creation of the patient’s medical record, which must be accurate in order to provide appropriate treatment and care, but, in addition, a healthcare provider’s ability to estimate cost and collect payments directly correlates to an efficient and accurate registration process.
To get all this done in a timely and accurate fashion is a major challenge for hard pressed registration staff; a new and innovative approach is needed to improve the registration process is to enable hospitals to not only access the information needed, but to customize the information to fit the required process, and then intelligently and automatically guide the patient-facing employees to use the information effectively through on-screen interactive guides.
To understand what I mean by the patient-facing employees being ”intelligently guided”, let’s examine one of the many registration processes that are key to the hospital’s overall revenue cycle: the insurance verification process. When a registrar has gathered enough information for the insurance verification process to be initiated, a message is sent to the appropriate data source to validate that the patient does have that particular insurance plan – and it is in force at that point. The system then validates the terms of the plan and establishes the copay amounts; sending that information back to the registrar during the patient registration in a user friendly form and automatically prompting the registrar to use the information, and then be guided to the next set of relevant questions in the process.
With other methods, the insurance verification information received from the various sources is not readily available in an easy-to-use format. The registrar has to interpret the information and glean whatever information is relevant. On the other hand, with a system like the one described above, the data is automatically interpreted and the appropriate set of prompts is shown to the registrar to enable the correct interaction with the patient and then seamlessly continue to the next step in the registration process.
The days of the bolt-on or standalone point solution are over! A vital requirement is that systems seamlessly integrate with the healthcare provider’s existing patient registration system and back office systems enabling the hospital to have a patient registration system that determines who is going to pay for the treatment and in what shares it is going to be paid.
Innovative systems like this can vastly improve the hospital’s revenue cycle, reduce losses and make money available to be spent where it really matters – providing a better service to patients.

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