According to a report by the Healthcare Financial Management Association, rework in medical revenue cycle management consumes 80% of the billing office’s time. The reworks are usually rectification of the error and omissions of information. Continuous rectifications cause back-office work to pile up. The pile of work increases delays, denials, increases in account receivable, and claims that end up in write-offs.
Although the large hospitals bear this burden, whereas small hospitals have to face a two to three percent gross profit rate, every unpaid claim adds to the bottom line of the provider’s financial statement.
So, one can say the money is collected or lost even before the services are rendered. Correct pre-registration can be considered the cornerstone of Revenue cycle management.
Definition of Pre-registration
Pre-registration is defined as the first encounter with a patient. For the uninterrupted RCM earning, the process of pre-registration must be efficient and correct. You must use the first encounter with the patient to clear all the financial ambiguities. Hence, your front-desk office must be trained enough to create a correct picture of the patient’s payment and collect and convey all the expenses to the patient.
Basics of pre-registration
You must complete administrative work in advance from the scheduled appointment with the care provider. Pre-registration decreases the error chances during face-to-face interactions. Prior to the scheduled appointment, your front desk office must maintain a proper account or form. Pre-registration includes the following.
- Verification of the geographical location
- Insurance coverage
- The verification of the benefits
- Intimate patients about financial responsibility.
To generate profitable revenue cycle management, care providers must consider the steps of pre-registration
Verification of the geographical address and demographical data.
The verification of geographical address, reviewing the social security number, demographic information like complete, age, gender, etc. The verification of the data is significant because it is a confirmation that a patient is genuine and the record provided by him is correct. This is also a regulatory requirement as well.
According to healthcare rules and regulations, the hospitals require to confirm the proper personal information of the patient to reduce patient identity theft. People who want to fraud steal patients’ personal information to get the benefits for others. According to Federal Trade Commission’s survey report mentions that around 5 percent of the healthcare record is stolen and then used for the further sale of data or use of data.
The most important part of pre-registration is insurance validation. After the appointment, you have to check whether the patient is eligible for the specific services or not.
- Confirm Deductibles,
- Verify referrals/ Pre-authorization
- Confirm secondary insurance coverage Like Medicare/Medicaid
You can use one among the below mentioned methods to confirm the information regarding insurance
Call the Payer: The first method is to directly call the payer and verify. This method is applicable to small clinics and health facilities where the number of patients is limited.
Fax: Fax is also helpful in collecting the payer’s information. This is a bit efficient way. This method of verification is also good for small healthcare entities.
Self-Service Portals: with the advancement in technology, self-service portals are designed. Hospitals can request access to the data. This is the fastest and most effective process of verifying data.
Integrated solutions: Some medical billing companies offer clearinghouse facilities. They have access to the maximum insurance providers. Outsourcing a medical billing company helps you to speed up the process.
Automated Insurance verification process: An automated tool for insurance verification is developed. AI-enabled verification tool is efficient and reduces the cost of verification up to 90%.
Financial Clearance and initial collections
The upfront collection is another important part of pre-registration. Initial collections and detailed information help streamline your accounts receivable. When a patient pays a sum amount directly to the healthcare provider, there are chances that he will not switch to other. You must give complete information regarding finances, including an upfront payment and the part of the payment you will receive from insurance companies at the time of the first visit of the patient.
In most healthcare offices, the upfront collection process is manual. Medical Billing software is developed to reduce the chances of defalcation.
The Goal achieved: Patient Satisfaction.
The major benefit of pre-registration is patient satisfaction. Because if a patient does not have knowledge of the healthcare provider’s fee, he can be frustrated or refuse to pay after the services are rendered. Secondly, if the patient falls in the category of services you are not providing, he may move to the right department. Overall this experience is satisfactory for both your front office staff and the patient.
Points to consider when streamlining your Pre-Registration process
The first step of your revenue cycle starts at your front desk office. So, to streamline your processes, you must train your front desk staff. You can aid your staff with medical billing software. The accurate tools and technology help your staff to perform efficiently. A centralized EHR software with properly built-in forms and sections can help the process of the revenue cycle management streamline. A complete and correct data collection assures clean claims management as well.
You can choose the best medical billing company to support you in all of your back-office support, including pre-registration services.
You must train your staff regarding pre-registration services or outsource this function of your medical entity to the best medical billing company.