This article was developed from an episode of Graphium Health's “Time Out For Anesthesia” with Courtney Franco, Vp of Sales at Imagine Software. You can watch or listen to the original interview by clicking the banner below.
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Technology, data, reimbursements, billing, revenue cycle management—none of it matters if we don’t keep our focus on the most important aspect of why we’re doing what we’re doing: The Patient Experience. If we’re positively affecting the bottom line, fantastic. Do anesthesia providers & groups need to make more money? Definitely. Do their books need to be accurately reconcilable? Yes, absolutely. But if we only focus on the bottom line, we’ll all get burned out. So we bring our focus back again to the patient experience. How is technology affecting the patient—especially in a post-COVID world?
Perhaps the best starting point to refresh our perspectives is this: we are all patients. We shouldn’t just speak about someone at given touch points in a perioperative process. You and I, at some point, are patients and will take our own part in the patient experience. With that in mind, perhaps the data that we protect and the people that we serve take a more appropriate priority in our minds and hearts.
Making the patient experience better, though, can be really challenging from a billing perspective, especially in a medical situation where the procedure is not elective but traumatic. Following up a traumatic experience with a stack of medical bills might understably feel overwhelming and chaotic—two feelings that quickly degrade the patient’s perception of the overall healthcare experience. And certainly if the patient isn’t well-informed of the healthcare space and how many different bills they might receive, navigating payments and records and communications may be a nearly, at least at first glace, insurmountable task.
How do we begin to combat that all-too-common experience? First, we need to be able to properly communicate patient balances in better, patient-facing statements. Ensuring clarity on those statements is paramount: What portion will be covered by the insurance? What portion remains the patient’s responsibility? And if the patient is still indeed responsible for payment, what is the easiest way to make that payment?
Technology has already begun to answer these challenges. Consider the QR code. That technology has actually been around for a pretty good while. It had some usage, but seemed to mostly be used as a quirky mechanism for smartphone users. Then came COVID, and all-of-a sudden, the QR code was being used everywhere. Even now I have a hard time thinking of a restaurant where I actually receive a physical menu any longer. I scan a QR code and go. In similar fashion, forward-thinking billers have begun to include the QR code on patient invoices. With just a scan, the patient is instantly taken where they need to go and has access to the correct resources.
But even before a patient receives a bill, technology holds another key to the patient experience: Data. Considering the demographic data of patients, the right data can determine a patient’s ability to pay. Many patient’s receive a high bill after a procedure—especially and unexpected traumatic procedure—and panic at the idea of how they’ll ever pay for it. But if we utilize that data appropriately, we can proactively offer payment plans where needed rather than requiring a patient to navigate that channel independently. This works well for everyone. It’s obviously great gesture to the patient that offers a more palatable way to make payments, but it also poses distinct advantages for the anesthesia provider or anesthesia group. You might realize revenue where previously you might have received no payment at all. Furthermore, if you practice independently you get to demonstrate to your community that you are sensitive to its needs as you engender trust and longer lasting relationships.
In many areas of the country, we find healthcare systems with high volumes of self-pay patients. Collections along those lines can become really complicated. On one hand, you need to get paid for your services. But on the other hand, how do you, at the same time, express compassion for the patient who has just experienced a life-changing trauma? Hardly anything is worse than a surprise bill in the middle of recovery. So proactive data-based billing can be vastly meaningful in the patient experience.
Some technology that is currently emerging for anesthesia providers is pre-payment collections. Anesthesia tends to be the lowest on the totem pole when it comes to up-front collections, and seldom is someone at registration ensuring that the anesthesia bill gets paid. Instead, patient’s get home after the procedure and find an additional bill from the anesthesia group—which can be not only surprising, but also confusing. Instead of surprising your patient, new pre-payment collections technology allows your group to send the patient a text before the time of surgery to explain the anesthesia service you’re providing, how much of it will be their responsibility to pay, and even allow them to make a payment up front. For the patient, this means clarity and confidence. For most anesthesia groups, this means an increase in revenue. For groups who have a larger cross-section of self-pay patients, this is game-changing. After all, the patient is the 3rd largest payer in healthcare after Medicare & Medicaid.
As a patient yourself, imagine, instead of simply receiving a surprise bill in the mail, that you receive a text message from a system that has already evaluated eligibility, your insurance policy, copays & deductibles, and is able to tell you, “You have a procedure coming up, and this is where you stand with your current deductible. You should expect to pay this much. Before your procedure, please make a payment of [insert amount here] by clicking on the following link.” This kind of experience would be SO much better than what has become typical in the healthcare space. And guess what: The technology already exists.
The opportunity lies mostly in the idea of bringing all of the often disparate systems together, which will result in a much better patient experience all the way from registration to collection of balance. Any type of collaboration between the EMR, the clearing house, the billing application, etc. is a step in the right direction. Interoperability is absolutely essential, though it is often a hurdle that is probably best saved for a blog post of its own.
But perhaps all of these conversations and technological developments can move in a positive and meaningful direction if all the players will keep this core concept in mind: “We are all patients. How would we like our own experience to go?”