As featured in Healthcare Tech Outlook
Published: December 10, 2021
Over the last decade, the healthcare industry has undergone various reforms, especially in revenue cycle management. From a fee-for-service protocol to a value-based compensation system, the payment reimbursement model in the United States has been shifting to help improve the quality of patient care and lower costs. Yet, despite the developments, healthcare organizations still are in need of effective solutions for verifying patient data and efficiently collecting reimbursements. To that end, two major challenges persist:
1. Though healthcare organizations are typically known for caring for patients, the reimbursement process and the application of health insurance coverage has always been complex and can cause its own type of discomfort to the patient.
2. Inaccurate patient demographic, insurance, and financial data exacerbates the issue and can cause a host of unfavorable effects for the patient as well as their healthcare provider and lab.
These two challenges often go hand-in hand. For example, a patient’s insurance coverage may not apply to a specific service so without accurate and complete information, the patient’s cost may not be correctly estimated. The patient may see a provider and have lab tests taken, only to receive a surprising bill afterwards, leaving the patient understandably upset and the healthcare payment in jeopardy.
These challenges – and others – impact the patient experience, according to John (JD) Donnelly, CEO of FrontRunnerHC. Donnelly urges clients to define the patient experience with a broad lens. “With consumerism becoming more important, the patient experience must be looked at not only in respect to their clinical journey, but their financial journey as well. Leveraging data automation to ensure the patient financial journey is as smooth as possible benefits both the patient and the healthcare organization. In an environment of declining reimbursements and increasing expenses, every opportunity must be taken to collect dollars quickly and retain those dollars, all while ensuring a positive patient experience.”
FrontRunnerHC spends a lot of time thinking about the steps along the Patient Financial Journey and the many problems that can negatively impact the patient’s experience – from the time a patient is registered for a healthcare visit to the time the bill is hopefully paid in full. These problems often stem from missing, incomplete, or invalid patient data.
The lack of real-time, accurate patient information can cause bottlenecks throughout the healthcare process. Already-scarce resources waste time hunting down correct information, making multiple calls or sending letters to insurance companies, referring physicians, or patients. The result? Not only wasted time but irritated patients and physicians, bothered by the inconvenience.
Donnelly offers good news however, saying that “while data-related problems can wreak havoc throughout the patient financial journey, the right data is out there and quickly accessible with the right data automation tools.” How quickly? 1.6 seconds actually. That’s the time it takes for FrontRunnerHC’s tech-tool called PatientRemedi to find, confirm, and fix a patient’s demographic and insurance information, leveraging its proprietary access to the largest payer network with 3000+ regulated data sources. The SaaS-based solution is interoperable with the client’s patient records or billing system, and there are no integration fees. Their Financial Disposition tool also provides insight into the patient’s specific financial information including their propensity to pay, helping providers make decisions that are best for their patients while optimizing collections.
Like most things, the earlier you solve a problem, the better. While FrontRunnerHC’s software can be leveraged anywhere in the process, they encourage clients to capture the accurate information as early as possible. Since its launch earlier this year, their LabXchange solution helps clients like the State of Kansas Department of Health and Environment electronically register patients and ensure accurate information upfront.
While a smooth start is important, it’s critical to keep that flow going. That includes communication with patients. FrontRunnerHC’s PatientXchange enables providers to text or email patients to deliver test results or accelerate payment. FrontRunnerHC is also launching a solution called ReadiPass to enable validation of test results or vaccination status to help patients meet compliance requirements such as for travel or event entry. FrontRunnerHC rounds out its software offerings with its White Glove Plus service, in which their experts act as an extension of their client’s team to solve the most complex claim and billing problems that cause healthcare claim denials.
Considering the future roadmap, Donnelly hints at some exciting new tools in the works to help clients further enhance their Patients’ Financial Journey while increasing their bottom line, including one to help predict insurance eligibility in the event the patient’s insurance coverage is undiscoverable. Donnelly states that “our core values are collaboration, innovation, and agility, and while we just celebrated our 11th anniversary, we’re just getting started”.
Original article as featured in Healthcare Tech Outlook