ActiveASSIST: Integrating Presumptive Charity and Propensity to Pay Solutions
Posted on Tuesday, August 3, 2021
ActiveASSIST is fully integrated with presumptive charity and propensity to pay solutions to help identify candidates for financial assistance.
ActiveASSIST is fully integrated with presumptive charity and propensity to pay solutions to help identify financial counseling prospects and to guarantee that all patients are provided the same fair and level assessment during financial assistance screening.
What is ActiveASSIST?
ActiveASSIST is our real-time financial assistance screening and workflow management solution. Our solution is designed to:
Identify patients who may be candidates for financial assistance.
Find alternative funding sources for patient accounts.
Segment and prioritize patient accounts based on propensity to pay.
Provide payment collection options based on each patient’s situation.
How Does ActiveASSIST Utilize Presumptive Charity and Propensity to Pay Solutions?
Presumptive charity solutions determine the likelihood that a patient will qualify for financial assistance based on factors such as demographic data, household size, income, and charity approvals previously made by the hospital.
Propensity to pay solutions assess patients’ ability to pay, identifying which patients are likely to make a payment and which patients should be extended financial assistance options.
Combining these solutions with a basic questionnaire integrated into the (pre)registration process, ActiveASSIST can identify a likely financial assistance prospect and route the patient history, visit information, and electronic application forms to internal counselors or hospital-approved vendors for follow-up.
The following ActiveASSIST features enable you to more effectively manage your self-pay patient population and financial assistance workflow:
Quick Screens – Basic questionnaires combined with the presumptive charity result identify likely prospects for financial assistance early in the revenue cycle.
Plan Code Recommendations – Recommended plan codes are presented to the registrar according to business rule selection and prioritization based on the “payer of last resort.”
Calculation of Charitable Co-Pay
Full Assessments – Comprehensive patient interview captures detailed information in the facility, in the field, or at contracted vendor locations.
ActiveASSIST not only determines which patients are candidates for financial assistance, but also manages financial assistance workflow to ensure that patient accounts and financial assistance applications progress at an acceptable pace. ActiveASSIST can monitor and enforce specific documentation requirements for each financial assistance program and flag and assign deficiencies to associates for resolution.
The Benefits of Presumptive Charity and Propensity to Pay Solutions
Implementing financial assistance screening technology that integrates presumptive charity and propensity to pay solutions provides numerous benefits, including:
Removing guesswork from financial assistance and patient collections activities.
Streamlining financial assistance and patient collections decision-making.
Directing patient collection efforts toward those most likely and able to pay.
Contact us to learn more about how ActiveASSIST utilizes presumptive charity and propensity to pay solutions to help your patients obtain financial assistance and help you reduce uncompensated care; or, view a short demo here.
ActiveASSIST: Financial Assistance Screening for Rural Patients
Posted on Monday, May 17, 2021
Patients are now responsible for a larger portion of healthcare costs than ever before. Even those who have health coverage may be considered “underinsured” due to high cost-sharing plans that leave them with significant out-of-pocket expenses they often cannot afford to pay.
12.5% of U.S. adults ages 19 to 64 were uninsured.
43.4% of U.S. adults ages 19 to 64 were inadequately insured
(uninsured, underinsured based on out-of-pocket medical costs compared to income, or experienced a gap in coverage).
Rural patients are more likely to be uninsured than are non-rural patients.
The financial viability of rural healthcare facilities will depend on their ability to find alternative funding sources for the medical bills that their patients may not be able to pay.
ActiveASSIST: Financial Assistance Screening for Rural Patients
ActiveASSIST is HealthWare Systems’ financial assistance screening tool and workflow management solution. ActiveASSIST identifies potential funding sources for patient accounts prior to their date of service and ensures the provider is payer of last resort by exhausting all other options first.
ActiveASSIST streamlines and automates the financial assistance process by:
Utilizing business rules to determine which patients are most likely to qualify for charitable assistance.
Simultaneously pursuing multiple assistance programs for these patients.
Pre-populating patients’ application forms with their data.
Providing real-time updates, while monitoring progress and documentation requirements.
Tracking follow-up tasks and escalating accounts that are not advancing at an acceptable pace.
Implementing ActiveASSIST at your facility does not require you to hire additional employees – our solution is designed to enable your internal staff, on-site vendors, and/or off-site and field associates to manage your self-pay and underinsured patient population.
Improving healthcare access with financial assistance screening for rural patients.
ActiveASSIST aids staff with follow-up and counseling discussions, helping them provide compassionate, supportive guidance and providing payment collection options based on each patient’s situation.
Improving Healthcare Access for Rural Patients
Many rural patients face unique barriers to healthcare access, which may include living long distances from healthcare facilities and specialists, poverty, provider shortages, and rural hospital closures or service cutbacks – and each of these has been exacerbated by the COVID-19 pandemic.
As mentioned, rural patients are also more likely to be uninsured than are non-rural patients. Unfortunately, insufficient health coverage is a major barrier to healthcare access and can cause patients to delay or avoid medical care altogether.
With ActiveASSIST, you can both alleviate your patients’ financial burden and enhance the financial outlook of your own organization to ensure you remain open and can continue serving your patients and community.
Research reviewed by the CDC found that by “June 30, 2020, because of concerns about COVID-19, an estimated 41% of U.S. adults had delayed or avoided medical care including urgent or emergency care (12%) and routine care (32%).” Consequently, the Becker’s Clinical Leadership & Infection Control editorial team included “missed and delayed diagnoses” and “low vaccination coverage and disease resurgence” on its top ten list of patient safety issues for 2021.
Besides worry about the pandemic keeping patients away, other barriers to healthcare access include a lack of (or inadequate) health coverage.
Solutions: A patient outreach campaign can bring patients back for preventive health services and encourage them not to forgo urgent care when they need it. Patients may be confused about the guidelines for seeking medical care during a pandemic. Receiving clarification directly from your organization will reassure them of the importance of obtaining routine and emergency care for their own health and safety. You can find patient outreach messaging ideas here.
HealthWare Systems’ ActiveXCHANGE solution can be bundled with our messaging platform to add automated voice message (TTS), text, email, pagers, fax, and traditional mail to create a physician and patient outreach engine for alerts, reminders, requests for information, and post-acute care follow-up.
When it comes to your uninsured and underinsured patient population, you can improve their access to healthcare by finding alternative funding sources for their medical bills. ActiveASSIST is our financial assistance screening solution that identifies which charitable programs patients may qualify for and manages the application process for them. This patient advocacy tool helps remove financial obstacles to healthcare access.
Patient Safety Challenge:Potential Exposure to COVID-19
While it may not be in a patient’s best interest to evade medical care altogether due to COVID-19 fears, there is still a risk of exposure to the virus when visiting a health facility.
Solution: Most health systems are now enforcing visitor restrictions to limit the number of people on site at their facilities. But have you considered reducing the number of employees on site as well?
With fewer people on site, the risk of exposure to COVID-19 will be lower for both patients and healthcare employees. Patients will also be more willing to come in for medical care if they know every possible measure has been taken to limit their risk.
Healthcare organizations continue to experience problems electronically exchanging information both externally (between different health systems) and internally (between different units/departments). Individual patient safety, as well as public health, depends on a provider’s access to accurate and complete data for each patient.
Unfortunately, “patient matching in the EHR” and “fragmentation across care settings” were included on the ECRI Institute’s top ten list of patient safety concerns in 2020.
Solutions: Our integration capabilities can introduce universal master patient indexes across disparate systems. This makes it possible to link episodes of care and supporting documentation across fragmented systems. Our electronic forms solution, ActiveFORMS, protects patient safety by enhancing patient data accuracy. ActiveFORMS uses barcode automation to correctly match patients’ medical forms to their accounts and auto-populates patient data on forms to prevent human error from manual entry or illegibility issues from handwritten forms. It also improves clarity by converting raw data into easy-to-read reports and transforming legacy reports into user-friendly documents.
Providing a bi-directional gateway for consolidating information from any source (e.g. multiple scheduling systems, custom interfaces, HL7, FHIR, XML, web-based requisition systems, EHRs/EMRs, faxes, direct messaging, e-mail, hard copies, scanned documents/images, and verbal appointments).
Routing information through business rules and account matching to the appropriate destination (e.g. EMR, physician portals, document management systems, other third-party applications) in virtually any format.
HealthWare Systems specializes in integrating proprietary and third-party patient access technologies and connecting disparate health IT systems and EMRs/EHRs.
Many EMR frustrations and administrative burdens can be traced back to interoperability issues (e.g. sifting through an overwhelming abundance of low-quality data to find relevant information, spending more time with the computer than with the patient).
Intelligently managing information objects by using business rules to find and create actionable data, determining what to do with that information, and flagging errors and exceptions (e.g. detecting missing signatures or required forms/documentation) for resolution.
Handling incoming physician orders/third party documentation to greatly reduce physician complaints related to lost or incomplete orders.
ActiveXCHANGE also does not require referring physicians to change their behavior or learn new software.
Increase Patient Collections Through Patient Financial Education
Posted on Monday, February 3, 2020
Addressing patient financial education needs can help you increase patient collections. When patients understand their medical bills, health insurance, and patient responsibility, they are much more likely to make their payments.
The following solutions by HealthWare Systems can help you improve patients’ understanding of their financial responsibility and increase patient collections:
ActiveASSIST is our financial assistance and self-pay management solution. ActiveASSIST is a patient advocacy tool that aids staff in providing compassionate and supportive financial counseling to patients.
Increase patient collections by providing patient financial education.
ActiveASSIST identifies alternative funding sources (e.g. government programs, charitable initiatives) for patients. Many patients are unaware of the various financial assistance options available, or that they may qualify. Our patient-first technology finds potential matches for them, manages the application process, and monitors documentation requirements, deadlines, and follow-up tasks.
By educating patients about their financial assistance eligibility and helping them secure funding, ActiveASSIST can leave patients with a smaller, more manageable portion of their bill to pay (or their costs may be completely covered by financial assistance).
As our all-in-one revenue cycle platform, Facilitator can streamline your financial assistance workflow as well.
Additionally, Facilitator generates patient estimates and determines patients’ potential out-of-pocket costs. Patients want price transparency. If patients know what costs to expect up front, they will feel better informed. They are less inclined to be upset when they receive their bill and more apt to pay it.
With Facilitator, you can also review prior balances across multiple sites, collect payments, or set up payment plans to help patients understand and resolve their financial responsibility.
February is National Wise Health Care Consumer Month. This month we are reminded of the importance of empowering and educating patients so that they can make wise health care decisions, including wise financial decisions related to their health.
This is an opportune time to implement revenue cycle solutions that will improve patient financial education and, as a result, increase patient collections.
ActiveDEFENDER monitors the entire patient encounter to prevent errors that lead to reimbursement denials, delays, and underpayments. (Read here how ActiveDEFENDERreduced bad debt by 50% at Bon Secours Charity Health System.)
Resolution – Improve Collections
Facilitator can simplify collections with one-click access to a consolidated view of patient responsibility that includes prior balances (across multiple sites), out-of-pocket costs for the current visit, and qualifying discounts.
ActiveASSIST can help you better manage your self-pay population and ensure that you as the provider are “payer of last resort” by exhausting all other funding options for patients first (e.g. government-funded programs and charitable sources).
Resolution – Increase Patient Satisfaction
All ActiveWARE products create improvements that increase patient satisfaction. But one factor that especially affects patient satisfaction is patient wait times. ActiveTRACK is proven to increase patient satisfaction by reducing both registration and clinical patient wait times. In fact, ActiveTRACK reduced patient wait times by 75% at an acute care facility in the Chicago Suburbs.
There are many cost benefits of electronic healthcare forms as well. With ActiveFORMS, there is no need to pre-print and store forms or waste money destroying old pre-printed versions that can no longer be used due to new updates. Instead, forms are instantly and electronically delivered wherever a patient presents and can be printed on-demand if a physical copy is necessary. And if not, you can go paperless with electronic signature.
Resolution – Perform a Health Plan Audit
An annual health plan audit can help you maintain compliance with payor contracts and ensure your front desk staff are prepared to collect the appropriate co-pay or deductible from each patient. If you’re not already, resolve to conduct a health plan audit at least every year.
Have you set New Year’s resolutions for your revenue cycle?
What are your New Year’s resolutions for your revenue cycle? Chances are, one or more of our ActiveWARE products can help. Contact us today to learn more… and have a Happy New Year!
4 Ways to Build a Culture of Patient Advocacy at Your Facility
Posted on Wednesday, February 6, 2019
How can a healthcare facility practice patient advocacy? Of course, patient advocates offer wonderful support to patients. But providers can create a larger culture of patient advocacy at their facility as well by tackling a few key areas.
Here are 4 ways hospitals can support their patients and build a culture of patient advocacy:
1.) Address The Social Determinants of Health
Create a culture of patient advocacy with Patient-First Technology like ActiveASSIST.
Supporting your patients’ social needs is an incredible form of patient advocacy. It can also lead to better health outcomes and lower healthcare costs for your facility.
2.) Offer Financial Assistance Screening
A lot of patients don’t realize that financial assistance may be available to them. Many hospitals have changed their financial assistance policies to include not only the uninsured, but the underinsured as well.
Notifying patients of which programs they could qualify for demonstrates a great deal of patient advocacy. What really goes above and beyond, though, is facilitating the entire financial assistance process on behalf of your patients!
By exhausting all other payment options first, you also ensure the provider is payer of last resort.
3.) Alleviate Stressors Surrounding Costs and Payment
Larger-than-expected or difficult-to-decipher medical bills, as well as health insurance confusion, are major sources of frustration for patients. They can also result in unpaid medical bills and medical debt, or cause patients to forgo some health services altogether.
Reducing patient uncertainty concerning the financial aspects of their care would help you foster a culture of patient advocacy. Ensuring patients are financially cleared before arrival, generating estimates and identifying potential out-of-pocket costs, and setting up payment plans are all ways you can assist patients in this area.
What a perfect time to share educational materials and classes related to health insurance and financial assistance with your patients. Perhaps the best way to advocate for your patients is to help them develop the skills they need to advocate for themselves!
Each of these areas provides you with excellent opportunities for patient advocacy. Plus, there is a bonus: supporting any of these endeavors can ultimately improve your bottom line as well.
Practicing patient advocacy will help you support your patients, improve the patient experience, and offers financial benefits for all parties involved. Developing a culture of patient advocacy can truly pay dividends.
Increasing Preventive Screenings for Men at Your Facility
Posted on Thursday, November 1, 2018
Increasing preventive screenings for men at your facility can save patients’ lives. “Movember” is the perfect time to start working toward this goal.
Consider these ideas for increasing preventive screenings for men at your facility:
Educate your patients. Patients may be unclear on the correct or most-up-to-date recommendations for preventive screenings and may not realize when it is time for them to start discussing these topics with their doctor. Make sure your clinicians initiate the conversation when patients reach the proper age to begin making decisions about testing in case patients forget.
Use their time in the waiting room as an opportunity to reach your patients.For example, print educational materials on the back of wayfinding maps. If you use a lobby display screen or patient notification board, feature male preventive health facts periodically throughout your rotation of announcements. Or, incorporate moustaches into the backdrop of your screen to draw more attention to Movember and male health issues.
(Read here how one acute care facility used ActiveTRACK to promote customizable messages to patients in their waiting area.)
Accommodate your patients. Allow for evening and weekend appointments. Besides providing interpreters and educational materials in various languages, train staff to understand how culture affects health and healthcare decisions. Don’t let inconvenience or cultural barriers stand in the way of accessing preventive health care.
Talk to female patients about preventive screenings for men. Women make approximately 80% of household healthcare decisions. Since women can have such a large impact on male health, clinicians may want to bring up the topic when meeting with female patients. This could trigger a reminder for female patients to schedule appointments for their loved ones, or simply provide them with pertinent preventive health information to pass on to the men in their lives.
Start the Movember Healthcare Challenge at your facility.Compete against others in your industry to raise money to improve male health through the Movember Foundation. Raise awareness by growing a (or wearing a fake) moustache! Use the hashtag #Movember when you share the pictures on social media.
Take proactive steps toward increasing mammogram appointments!
October is the perfect time to focus on increasing mammogram appointments. During Breast Cancer Awareness Month, prioritize preventive care using the suggestions below.
Consider these ideas for increasing mammogram appointments at your facility:
Educate your patients on breast cancer prevention. Patients may be unclear on the correct or most-up-to-date recommendations for mammography screening or may have heard conflicting instructions from different organizations. Make sure your clinicians clarify.
“Current guidelines from the American College of Radiology and the Society for Breast Imaging recommend that women receive annual mammograms starting at age 40 — even if they have no symptoms or family history of breast cancer.”
Ensure patients are aware that most health plans are required to cover the cost of a breast cancer mammography screening for women over 40 every 1 to 2 years (when performed by an in-network provider). Highlight the fact that most plans also cannot charge a copayment or coinsurance for this service even if the patient has not met her yearly deductible yet. Some states even require insurers to cover 3D mammograms. Instruct patients to check with their insurance company. Additionally, help patients find out if they qualify for financial assistance and facilitate the application process for them.
Send mammogram reminders through texts, emails, letters, postcards, and/or phone calls. A study conducted by Kaiser Permanente found mammogram reminders to be very effective in increasing mammogram appointments, especially when sent to patients whose mammogram appointments were coming due.
When patients check in, instruct registrars to ask them if they’ve scheduled their annual mammogram exam yet; and if not, have registrars try to schedule one with them. Additionally, registrars should confirm they have the correct mailing address and phone number for the patient in the system used to send mammogram reminders.
Use their time in the waiting room as an opportunity to reach your patients. For example, print mammogram reminders on the back of wayfinding maps. If you use a lobby display screen or patient notification board, include mammogram reminders and breast cancer prevention facts that appear periodically throughout your rotation of announcements. Or, use a mammogram reminder as the full-time backdrop of your screen.
(Read here how one acute care facility used ActiveTRACK to promote customizable messages, including encouragement of mammogram appointments during Breast Cancer Awareness Month, to patients in their waiting area.)
Improve patient engagement with preventive health by utilizing social media in healthcare. Share mammogram reminders, educational materials, and powerful statistics demonstrating the importance of early detection. For instance, according to the American College of Radiology, “mammography has helped reduce breast cancer mortality in the U.S. by nearly 40% since 1990” and “skipping a mammogram every other year would miss up to 30% of cancers.”
Accommodate your patients.Allow for evening and weekend mammogram appointments. Besides providing interpreters and educational materials in various languages, train staff to understand how culture affects health and healthcare decisions in order to reach patients of all backgrounds. Don’t let inconvenience or cultural barriers stand in the way of accessing preventive care.
Emphasize your goal of increasing mammogram appointments to your staff.Stratis Health suggests providing your clinicians and registrars with “missed opportunity” reports, which would demonstrate the number of patients who visited throughout the month who were due/overdue for their mammogram appointments but did not get scheduled.
October is the opportune time to launch a breast cancer awareness campaign! Of course, the suggestions above are best used throughout the entire year to help you in your goal of increasing mammogram appointments and improving your rates of early detection to save lives.
The Social Determinants of Health & Their Effect on Health Outcomes
Posted on Friday, August 17, 2018
The social determinants of health are increasingly on the radar of health professionals and health systems. The National Academy of Medicine (formerly the Institute of Medicine) even recommends this information be included in patients’ medical records.
Hospitals can utilize screening tools to collect patient data concerning the social determinants of health. While a provider may not be able to resolve all social issues faced by a patient, identifying them can help inform healthcare decisions. (Providers should also have a list of resources that attend to social needs available to provide the patient when asked.)
When health systems consider the social determinants of health when caring for their patients, all parties benefit. Patients have better health outcomes, communities improve, and health systems become advocates for their patients (improving patient satisfaction) while saving money. The social determinants of health not only impact the health of patients, but also the health of a hospital’s revenue cycle.
Social factors that influence patients’ health & healthcare decisions include:
Employment – A good job can provide a patient and his/her whole family with health benefits and insurance. Unemployment negatively affects physical and mental health.
Income – A steady paycheck allows a patient to pay for many of the other factors in this list, such as adequate housing, nutrition, and transportation, as well as healthcare costs. (Financial assistance screening tools can help patients find out if they qualify for charitable programs to help offset the cost of care, and enable hospitals to facilitate the application process for their patients.)
Housing – Poor living conditions increase the risk of infectious disease, injury, chronic illness, pest and mold problems, and indoor air pollution. And each year, 1.48 million Americans have no home at all. (Here are some examples of how hospitals can help meet patient housing needs.)
Violence – The area in which patients live also can affect their exposure to violence or abuse. Victims or witnesses to acts of violence may experience mental, physical, and/or economic consequences that affect their overall health.
Nutrition – A lack of consistent access to healthy food can negatively impact health outcomes and increase the risk of many adverse health conditions. Over 12.7 percent of U.S. households were affected by food insecurity in 2015. (Read our previous blog for more information on how to reduce patient malnutrition.)
Transportation – Access to reliable transportation can govern a patient’s access to medical care. Approximately 3.6 million Americans miss or postpone medical care due to transportation issues. (Check out these ideas for addressing patient transportation needs.)
Social Support – As reported by NPR, in a recent nationwide survey conducted by Cigna “nearly 50 percent of respondents” said “that they feel alone or left out always or sometimes.” Two in five respondents “felt like ‘they lack companionship,’ that their ‘relationships aren’t meaningful’ and that they ‘are isolated from others.’” Patients who feel unsupported are more vulnerable to poor health outcomes. (Read how physician empathy can generate better health outcomes.)
Language/Culture – Culture influences our beliefs about health and healthcare. A patient’s ability to communicate with health professionals may be impeded by language barriers.
Education –According to the CDC, people with higher levels of education are more likely to choose healthy behaviors and refrain from unhealthy ones. People with lower levels of education are more likely to be obese and more likely to smoke.
Sex/Gender – Many health conditions affect men and women differently and certain treatments may be more or less effective depending on the sex of the patient. Plus, men are less likely than women to see a doctor for a specific health concern, preventive healthcare, or a standard annual exam. (Consider these tips for improving male patient engagement.)
The social determinants of health are key to improving health outcomes and the revenue cycle.
It’s not difficult to imagine how the above factors might influence one another. The social determinants of health are interconnected and work together to impact a person’s health and healthcare decisions.
Patients whose social needs are unfulfilled are more likely to utilize healthcare resources at a higher cost (including the Emergency Department), be readmitted, miss appointments, and have poor health outcomes.
Reducing patient uncertainty should be a high priority item for healthcare providers. Feelings of uncertainty can affect the patient experience and lower patient satisfaction.
Most of us are uncomfortable with uncertainty and many visits to healthcare facilities are made with the purpose of diminishing it. Patients seek out your facility hoping to find answers to health questions; the last thing they are looking for is even more confusion.
Reducing patient uncertainty can vastly improve the patient experience.
Below are 6 areas that can either increase or decrease patient uncertainty.
By reducing patient uncertainty through addressing these areas, providers can greatly improve the patient experience:
For example, a study published in the journal Health Communication found that video biographies for primary care physicians were more effective in reducing patient uncertainty than the standard text biographies that most providers post on their websites.
2. – Wayfinding:
Navigating their way around an unfamiliar building can increase patients’ anxiety over their hospital visit. Wayfinding solutions (such as digital signage, mobile apps that guide patients around your campus, and touchscreen kiosks that print wayfinding maps) can ensure that patients and their visitors don’t get lost, all while reducing patient uncertainty about finding their destination.
3. – The Waiting Room:
The waiting room offers numerous opportunities for reducing patient uncertainty surrounding many topics. In the waiting room, uncertainty about wait times can be just as frustrating as the actual waiting. Patients’ family members face uncertainty as well, about how long they’ll be waiting, about the details of a procedure, and about the outcome for their family member.
Patients should not have to face uncertainty regarding whether their doctor has all the information he/she needs to properly care for them. Yet, only 46% of hospitals had required patient information from outside providers or sources available electronically at the point of care according to research posted by the Office of the National Coordinator for Health Information Technology.
Researchers have created a new tool called the Uncertainty Scale to measure patient uncertainty and predict hospital readmissions. Some of the major themes they’ve found in their work include patients’:
“Lack of clarity regarding self-management, such that patients are unsure how to deal with symptoms at home”
“Lack of self-efficacy, manifesting as patients not knowing where to go for help for certain symptoms”
“Lack of clarity about the decision to seek care, meaning that patients do not know which symptoms are serious enough to warrant seeing a health professional”
Uncertainty is unfortunately a common experience in healthcare for those with undiagnosed conditions and symptoms for which an explanation is unclear. The six areas outlined here are within your control; by reducing patient uncertainty in these areas, your facility can greatly improve the patient experience.