Business process automation in healthcare.

What is Business Process Automation? (And How Can Healthcare Facilities Use BPA?)

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HealthWare Systems Blog

What is Business Process Automation?

(And How Can Healthcare Facilities Use BPA?)

Posted on Tuesday, March 17, 2020

Business process automation (BPA) is the digital transformation of organizational workflows. BPA utilizes technology to automate manual, repetitive, routine tasks and to streamline processes. BPA applies business logic to respond to events, make information “actionable,” and anticipate next steps to proactively manage workflow.

Benefits of Business Process Automation

Business process automation enables organizations to assign their valuable time and employees’ skill sets to other objectives while technology takes care of the monotonous, time-consuming, and routine operations for them.

In addition to time, BPA saves organizations money. It is a cost-effective way to increase efficiency and speed up workflow. Plus, digital transformation of business procedures reduces paper usage (making processes more budget and environmentally friendly).

By limiting the opportunity for human error, BPA also improves accuracy and prevents deficiencies.

Business Process Automation in Healthcare

HealthWare SystemsFacilitator is a business process automation platform created specifically for healthcare.

Facilitator can apply BPA to the following areas that affect the healthcare revenue cycle:

Business process automation in healthcare.

Facilitator is a BPA platform built specifically for healthcare.

Pre-Arrival – prevents integrity issues that can result in technical denials or underpayments.

Prior Authorization – automates authorization requests using 278 transactions, web-crawling, fax requests, and payer portals; automatically checks status of pending authorizations; monitors status changes that affect patients’ authorized benefits.

Insurance Verification – verifies insurance in real time; identifies potential restrictions that may impact reimbursement; finds any unreported coverage by searching top regional payers.

Medical Necessity Checking – verifies medical necessity in real time; shares results with referring physician; produces ABN for patient signature; provides automated updates of LCD and NCD rules.

Financial Assistance Screening – determines the likelihood that patients will qualify for financial assistance; manages documentation requirements and selects/completes application forms based on eligibility program(s) pursued.

Appeals Management – routes denial work object to appropriate team member for resolution; generates appeal letter or form specific to payer or denial type; assembles appeals package and submits appeal; eliminates hard copies.

Release of Information – securely captures, gathers, and sends medical records; eliminates hard copies.

Electronic Medical Forms – business rules determine the correct forms needed for every patient’s specific encounter, so employees no longer need to memorize selection criteria; pre-populates forms with patient demographics.

Order/Referral Management – fast-tracks pre-registration by ensuring accurate and complete physician orders are received.

Automated Messaging – reminds patients of upcoming appointments.

And More


Is “BPA” in Your Site’s DNA? 

Business process automation is increasingly necessary for the success of today’s organizations, including those in the healthcare field. Through BPA, hospitals and health systems can streamline workflow while lowering costs, better allocating resources, and increasing accuracy.

Request a live demo to learn more about how you can transform workflow at your healthcare facility using business process automation.


By Stephanie Salmich

A patient advocate provides financial counseling, which can increase patient collections.

Increase Patient Collections Through Patient Financial Education

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HealthWare Systems Blog

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.

When patients are confused about what they owe and why, they often delay payments or don’t make them at all. Too many patients experience health insurance confusion and anger and uncertainty concerning medical bills and healthcare costs.

The following solutions by HealthWare Systems can help you improve patients’ understanding of their financial responsibility and increase patient collections:


ActiveASSIST

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.

A patient advocate provides financial counseling, which can increase patient collections.

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).


Facilitator

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.


By Stephanie Salmich

What are YOUR New Year’s resolutions for your revenue cycle?

New Year’s Resolutions for Your Revenue Cycle

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HealthWare Systems Blog

New Year’s Resolutions for Your Revenue Cycle

Posted on Wednesday, December 18, 2019

Have you set any New Year’s resolutions for your revenue cycle?

The new year is upon us! The following are a few resolutions you’ll want to consider for improving your revenue cycle, along with the ActiveWARE products that can help you reach these goals.

New Year’s Resolutions for Your Revenue Cycle


Resolution – Financially Clear Patients Prior to Date of Service

Facilitator is a pre-arrival workflow solution that can streamline prior authorizations. And not only does Facilitator automate financial clearance steps, but it also verifies insurance and medical necessity in real time and searches for unreported coverage.

Resolution – Reduce Technical Denials

ActiveDEFENDER monitors the entire patient encounter to prevent errors that lead to reimbursement denials, delays, and underpayments. (Read here how ActiveDEFENDER reduced 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.

Resolution – Reduce Paper Use and Costs

Our digital transformation solutions greatly reduce paper use and costs. For example, ActiveXCHANGE, our digital order management solution, eliminated 1.3 million pages per year at Advocate Illinois Masonic Medical Center.

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.

What are YOUR New Year’s resolutions for your revenue cycle?

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!


By Stephanie Salmich

Physicians hold a thumbs up sign for solutions that can streamline prior authorizations.

Streamline Prior Authorizations with a Pre-Arrival Workflow Solution

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HealthWare Systems Blog

Streamline Prior Authorizations with a Pre-Arrival Workflow Solution

Posted on Monday, July 1, 2019

The results of a recent survey conducted by the American Medical Association illustrate the importance of solutions that can streamline prior authorizations.


The 2018 AMA Prior Authorization Physician Survey found the following:

  • 91% The percentage of physicians who say the prior authorization process postpones patients’ access to necessary care.
  • 28% The percentage of physicians who say the prior authorization process has resulted in a serious adverse event for their patients (e.g., “death, hospitalization, disability/permanent bodily damage, or other life-threatening event”).
  • 86% The percentage of physicians who describe prior authorization burdens as high or extremely high.
  • Almost 2 Business Days (14.9 hours) The average length of physician/staff time that is devoted to prior authorization requirements per physician per week.
  • 36% The percentage of physicians who have employees who work solely on prior authorization tasks.

Clearly, health systems face many challenges related to preauthorization.  Patient safety is compromised when care is delayed.  Patient and physician satisfaction are at risk as patients endure frustrating waits for treatment and physicians deal with administrative duties that disengage them from their medical work.

And not only can each prior authorization be costly, but excess costs are also incurred in the forms of extra clerical staff and rework when prior authorizations are denied and must be resubmitted.


According to CAQH CORE, 88 percent of prior authorizations are completed either partially or completely manually; and, the majority of preauthorization issues are related to manual processes.

A pre-arrival workflow solution can automate manual processes and streamline prior authorizations.


With a pre-arrival workflow solution that can streamline prior authorizations, you can address the issues mentioned above:
Physicians hold a thumbs up sign for solutions that can streamline prior authorizations.

A pre-arrival workflow solution can streamline prior authorizations and improve staff and physician satisfaction.


Support your physicians by utilizing solutions that make their jobs easier.  Implementing time-savers for physicians can go a long way toward reducing physician burnout, which is often related to stressful and time-consuming administrative workloads.

In addition to increasing physician and employee satisfaction, a pre-arrival workflow solution will improve your revenue cycle and patients’ access to care they need.

Hospitals can no longer afford to delay employing solutions that will streamline prior authorizations and benefit all stakeholders in their organizations.


By Stephanie Salmich

Reducing patient uncertainty: Healthcare providers connect puzzle pieces.

Reducing Patient Uncertainty: 6 Areas to Address

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HealthWare Systems Blog

Reducing Patient Uncertainty: 6 Areas to Address

Posted on Wednesday, May 9, 2018

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: Healthcare providers connect puzzle pieces.

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:

1. – Online Presence:

A strong online presence and positive online reviews can aid in reducing patient uncertainty by helping patients become more familiar with your facility and organization before they even visit.  Utilize your website and social media accounts to their full advantage.

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.

A patient tracking board and real-time text updates can be instrumental in reducing patient uncertainty and lowering waiting room anxiety for patients’ family members.  Patients can better gauge how long they’ll be waiting, and patients’ family members know their loved one’s status at each stage (e.g. “in prep,” “in surgery,” “in recovery”) of the encounter.

4. – Interoperability:

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.

With odds like these, patient uncertainty about transfer of medical records or if a physician’s order/referral will be received in time is warranted.  Reducing patient uncertainty can be accomplished by ensuring your facility can electronically send, receive, find, and integrate/use all necessary health information.

5. – The Discharge Process:

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”

Improving patient education during the discharge process can help in reducing patient uncertainty about self-care, where to seek help, and when it is necessary to seek help, as well as lower readmission rates.

6. – Payments:

Patients want price transparency and as wise healthcare consumers, they have the right to be informed about the use of their healthcare dollars.  Confusion about health insurance and how much money they owe for health services, even after they’ve received a bill, is a source of patient uncertainty.  Patients may have great clinical outcomes, yet, if they are surprised when the bill is larger than expected, their satisfaction surveys will reflect low scores.

Providing estimates for out-of-pocket costs upfront, helping patients with insurance issues, preventing insurance-related errors, and helping patients identify and apply for financial assistance opportunities can all help in reducing patient uncertainty about cost.


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.


By Stephanie Salmich