Embracing the Virtual Patient Experience: Why Access is Ground Zero for Digital Transformation

The days of the clipboard are over.

We’ve all been there: sitting in a crowded waiting room with a clipboard balanced on your lap, filling out a never-ending stack of the same forms you’ve filled out dozens of times. It’s frustrating, tedious, uncomfortable, and in our current times, potentially unsafe. 

This scenario is no longer acceptable to patients (nor should it be) and providers must adapt. What does it take to embrace a virtual patient intake experience that benefits patients, staff, and healthcare providers?

A virtual patient experience is no longer optional

COVID-19 has ushered in a watershed moment for patient experience. Patients now not only prefer convenient, virtual experiences, they demand them – and will go elsewhere if their expectations are not met. In fact, 80% of patients who are satisfied with their care will still consider switching providers based on convenience factors alone. 

Providers have no choice but to address this new dynamic. Interactions and processes that have long been paper- and people-based must go digital. 

This starts with meeting consumers where they are – and where they are is online. Becker’s reports that “2020 saw a 37% increase in time spent online, giving patients more opportunities to seek out health systems that better align with the billing experience they expect to receive.” Their expectations are not just around billing, either. Today’s patients elect to do everything online, from scheduling appointments to completing paperwork to evaluating estimates to, yes, paying their bills. 

At each point of interaction with their providers, patients want an easy-to-use, streamlined virtual experience that offers greater flexibility, visibility, convenience, and control. Yet for many providers, while these expectations are clear, how to deliver on them is not.

The first step to going virtual: Focus on front-end revenue cycle processes

“Going virtual” can feel incredibly daunting. Provider organizations rely on so many processes, with so many parties, that untangling them all can seem like pulling apart a bowl of spaghetti. 

We have, however, been here before. The last 20 years have seen tremendous advances in the digital transformation of healthcare (think EHRs). We can take lessons learned from these endeavors and apply them to modernizing the patient experience: take it one step at a time.

Begin by focusing on front-end revenue cycle processes, including scheduling, financial clearance, and eligibility. These are critical to a number of downstream outcomes and often a source of enormous patient dissatisfaction. Take denials. 90% of denials are preventable. 24% of denials are due to errors in front-end processes, like registration and eligibility, while another 15% are due to “missing or invalid claim data” – also often a front-end culprit. 

In addition, denials add up fast. In the article Denial rework costs providers roughly $118 per claim: 4 takeaways, Becker’s reports that:

  • An estimated $262 billion, or 9%, of the estimated $3 trillion in claims submitted by hospitals last year were initially denied.
  • A typical health system stands to lose as much as 3.3% of net patient revenue, an average of $4.9 million per hospital, due to denials.
  • 63% of denied claims are recoverable on average, but providers spend roughly $118 per claim on appeals, or as much as $8.6 billion in administrative costs nationwide.

It’s clear that continuing to optimize the front-end not only impacts the patient experience, but it also impacts the financial health of the organization. This makes access a very smart place to begin the virtual patient experience journey.

Leave the lobby, waiting room, and clipboard behind

What does modern, virtual access look like in practice? It digitizes each component of the intake process, enabling patients to use their smartphones, tablets, and laptops to:

  • Locate providers and schedule their own appointments directly 
  • Complete and sign required forms and upload documents before their appointments
  • Shop for services and calculate the expected out-of-pocket costs 
  • Communicate with their provider via text 
  • Automatically notify providers of arrival with minimal or zero wait time, then proceed directly to point of care
  • Navigate around or through facilities with only their smartphones
  • Minimize physical contact with patient access staff
  • Pay bills, establish payment plans, or secure financing online prior to date of service
  • Keep family members informed and engaged (onsite and remotely)
  • Identify and schedule post visit referrals based upon location and time preference

When organizations provide these capabilities, they dramatically change the role of patient access. Instead of serving as transaction switchboards, patient access teams become experience concierges. They monitor the flow of each patient through the registration process, manage exceptions as needed, and guide the patient seamlessly, painlessly, and directly to the point of care. 

This shift has far-reaching implications. For patients, the experience is faster, more convenient, safer, and less frustrating. They can complete paperwork at home instead of sitting in the waiting room for half an hour with the dreaded clipboard. They can run an estimate for their services before the appointment, gain a clear understanding of their financial responsibility, and prepare accordingly, instead of facing a surprise out-of-pocket liability and on-the-spot decision at point of care. They can inform their care team that they have arrived, get directions to their point of service, and bypass the lobby filled with 50 impatient people, waiting and coughing. 

Each of these interactions ultimately rolls up into greater satisfaction and increased loyalty. And if patients don’t experience them, they take action: 90% of patients would leave a healthcare provider that didn’t deliver a satisfactory digital experience. 

From tactical transaction managers to patient experience concierges

Patients are not the only beneficiaries of virtual patient intake solutions. The role of the patient access team transitions from tactical to strategic. Instead of hunting down hundreds of transactions or documents in dozens of systems, they can spend their time focusing on what really matters: the patient experience. The elevation of their role translates to greater employee satisfaction. Villanova University reports that employee satisfaction, in turn, results in lower turnover, higher productivity, increased profits, and greater loyalty.  

Finally, embracing a virtual patient experience directly impacts the provider at the business level. Alongside happier, more loyal patients and staff, organizations see measurable changes to their revenue cycle. Patients can pay for services at or even before time of service, so cash flow increases. Because they are paying upfront, and because virtual patient intake removes human error from much of the registration process, the cost to collect decreases. In other words, they see more cash, more quickly, and pay less on the back end. 

Those two metrics are perhaps the most important to any provider’s finance team. It’s striking that something as relatively simple as digitizing access can influence the revenue cycle so profoundly.

Final thoughts: Creating a financial experience that keeps pace with the clinical experience

I wrote in a previous Becker’s article, Cultivating Loyalty with Convenience, that while “Those of us who work in healthcare talk a big game in terms of patient engagement and offering patient-friendly options… we’re behind nearly every other industry.” This remains true, and to make matters more imperative, our patients’ expectations have caught up with us. COVID-19 changed the game, so the time for change is now.

It’s time to match the financial experience with the clinical experience. Of course, it’s critical to deliver great quality of care and desirable outcomes. But just like we have historically focused on creating a positive end-to-end clinical experience, from empowering the triage nurse to minimizing the length of stay, we must now turn our focus to providing a great end-to-end financial experience. 

The patient experience, after all, encompasses both. We cannot improve the patient experience without addressing the financial elements of it. Even if clinical care is flawless, what happens when patients go home? They get hit by unexpected bills that they may struggle to understand and pay. They are asked to submit form after form. They receive calls from staff and agencies, demanding payment. All of these interactions can take a great clinical encounter and turn the overall experience decidedly sour. 

Providers that can offer mature, intuitive virtual patient intake services bridge the gap between the clinical and financial experiences. They give patients a holistic experience that spans their medical and financial expectations and requirements. They benefit their patients, staff, and bottom line. And in an environment that is now an arms race for differentiation, they gain the edge that they need to earn loyalty, trust, and satisfaction. 

The time is now. Let’s retire that clipboard.

Steven Huddleston is a seasoned revenue cycle executive and the CEO of PELITAS. In 2019 and 2020, PELITAS was named Best in KLAS for its patient access software and technology and currently maintains that position today. With more than 25 years of experience in provider healthcare, Steven has a proven record in leading organizations through periods of significant change, including: accelerating innovation and growth, integrating mergers and acquisitions, and building high-performing teams. 

Prior to joining PELITAS, Steven helped build the investment thesis and identify the acquisitions to launch nThrive and was subsequently appointed President, Service Solutions & Chief Client Officer. Prior to nThrive, Steven was a Managing Director in Accenture’s Healthcare strategy practice, where he worked with not-for-profit provider organizations and private equity-backed portfolio companies to drive business transformation through operating strategy and model design, technology selection, and post-merger integration change management. 

Steven spent 15 years with Hospital Corporation of America (HCA) in progressive financial and revenue cycle leadership roles. After leading revenue cycle operations at two shared service centers, he helped launch Parallon, a revenue cycle outsourcing subsidiary of HCA.

Since joining PELITAS in November 2018, he has positioned the company as the leader in patient access technology solutions to support hospitals and physicians by recruiting industry-leading talent, launching innovative solutions, and winning the Best in KLAS designation two years in a row.

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