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End-to-End Revenue Cycle Management

Patient (Not-So-Much) at the Center

Feeling like an outsider within the walls of your own healthcare provider is frustrating, especially for a revenue cycle leader—when he is the patient.  Here, MediRevv's SVP of Revenue Cycle Terry Reinsager shares a recent encounter. 

"It was supposed to be a simple, straightforward experience, but quickly turned into an annoying, inefficient Saturday afternoon."

After experiencing some major abdominal pain, I decided I better go into an Urgent Care Center to get things checked out. The nurse practitioner (NP) examined me and found out I needed imaging. She told me however I needed to go to the emergency room to get the imaging done. Even though she predicted the ER staff would come up with the same diagnosis as she did, they were the ones who had the power to order a CT scan.  I was frustrated, to say the least, because I had just wasted a few hours in Urgent Care, and now I had to make another trip for answers.  

When I went to check out of Urgent Care, I was not asked to pay my copay. So, I asked the administrative check-out person if I could pay my copay since I knew I owed it. Her response was “we will bill you later.” I couldn’t help myself and told her it was a bad practice (I work in revenue cycle strategy, so I know these things). She said “ok” but wouldn’t let me pay.  I was baffled at much money the organization was throwing away by simply failing to collect patient copays at the time of service. If she would have allowed me to pay upfront, she would have had a faster and easier reimbursement.  

Three hours had passed, and I was seen by a physician who came to the same diagnosis as the Urgent Care NP and ordered the CT scan for two hours later. I asked him if my CT scan needed to be pre-authorized, and he said the business office would take care of it later. I told him I was not comfortable doing the imaging before it was pre-authorized and wanted it done before the actual scan. He seemed annoyed but 30 minutes later the CT scan authorization was received. I couldn’t help myself again, probably the pain talking, and told him as a patient I shouldn’t have to ask for the call to be made to ensure coverage before the scan.  

My scan went well. I received my diagnosis and my medications. As I looked over the paperwork sent home with me from Urgent Care, my eyes popped at the last page attached. It said “Poisoning – ECG and EKG ordered ASAP due to chest pains”. I freaked out since it didn’t make any sense until I scanned the top of the document for the patient's name. The NP had given me the medical record order for another patient—a major PHI violation.  

I look back on my experience as a patient, and I am disappointed. The healthcare organization failed to put me at the center of their practice. I understand that providing care is their primary focus, but if they want to keep patients and continue to grow, the experience they provide needs to improve. Eliminating little frustrations and inefficiencies can make a big difference. Optimizing their system flow would have improved both my experience as a patient and their cash flow. 

I want to challenge healthcare systems to think about their patients being at the center of their operations. How can you create a better patient experience? What elements of a patient centered-design do you need to develop over the next 10 years? Do you have a mechanism for capturing your patients’ overall experience? Is your patient accounting system optimized for your revenue cycle? The patient experience you strive for on paper should align with your everyday practices. 

If you relate to any element of my story, consider a revenue cycle partner.

Learn more about our End-to-End Revenue Cycle Management

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