How to use technology to align incentives and improve patient flow

Where other sectors have already benefited from dramatic technological overhaul, healthcare has historically lagged behind.

Deeply entrenched processes combined with complex regulatory and security requirements, established to protect patient medical information, often create friction that prevents new technologies from entering the market. They similarly prevent providers from adopting new products.

But these challenges are not insurmountable. By using technology to respond to patient needs, vendors and providers can offer vast improvements to a patient's experience, and also reap rewards for their bottom line. Patient scheduling, check-in, and billing processes provide a few examples of where this has already proven true. Providers are increasingly partnering with new technologies to address healthcare’s inefficiencies and streamline these processes to benefit both patient and provider.

In most hospitals and doctors’ offices, the experience for patients goes something like this: patients show up for their appointments, sign in on a clipboard, and wait to provide the front desk with their insurance plans. The administrator behind the desk might take ten minutes to verify the patient’s insurance plan and determine how much they owe. Following the appointment, it’s typical to pay a small copay of $10 or $20 before leaving the facility, only to receive a totally unexpected and much larger bill in the mail a few months later.

Not only is this process frustrating and time-consuming for the patient, but also highly inefficient for the provider. Hospitals are hemorrhaging resources as they dedicate time and personnel to check-in processes that could be easily automated, while inaccurate cost-estimates often cost hospitals up to 50% of what they’re owed, totalling $375 billion dollars annually.

For these reasons, improving patient flow has become a priority at hospitals around the country. As new regulations add to the workload of the front-desk staff, hospital patients are experiencing longer wait times during check-in and check-out. Simple, predictable, and repetitive processes, such as informing caregivers of patient arrival, exchanging insurance information and collecting copays, continue to require resources that could otherwise be spent improving processes that boost quality and value and improve the patient experience.

Digital health leaders and healthcare IT developers are also adopting new technologies like Eligible, the healthcare billing platform I founded, to further streamline patient flow by automating insurance eligibility and the billing process. Providers and other patient-facing healthcare platforms use Eligible to verify insurance and provide patients with an easy-to-understand bill in advance of their appointments. Patients not only avoid the inconvenience of unexpected bills, months after their visit, but they’re given cost transparency that they can trust, which means they’re less likely to avoid care for fear of unaffordability.

Zocdoc, an online booking platform, is one technology company that healthcare providers are implementing nationwide to improve patient flow. Patients can find doctors that better fit their needs and their schedules, and book appointments online in a few clicks, while providers can boost visibility and cut time spent on administrative work. Zocdoc uses Eligible as part of its Insurance Checker feature, to perform real-time coverage checks, confirm that the selected doctor is in-network, and, if the data is available, display the patient’s expected copay.

While a clear benefit to the patient, this service is even more beneficial to the provider. Automating insurance eligibility and billing significantly reduces denied claims, increases overall collections, reduces bad debt, and cuts labor costs. For radiology provider Radnet, this resulted in millions of dollars saved. They increased revenue collected at the time of service by over 700% and freed up staffers to provide patients with more personalized care. For Zocdoc, using Eligible to verify patient insurance information and pass it to providers modernizes outdated processes and reduces time office staff spend on phone calls, leaving more time to spend with patients.

Though these few examples show that progress has been made, our healthcare system still calls for dramatic improvements that stand to benefit both patient and provider. Third party technologies have the potential to align patient and provider incentives, improving care while reducing costs. Technological innovation is a necessary component to the future of healthcare if the industry is going to navigate the industry’s numerous complexities and keep pace with other customer-facing sectors. It will take courage and commitment but the benefits to the patient and the provider will be well-worth the effort.

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