Patient Financial Services



PFS August

With the continued evolution of health care reform and the battle over its future, the only thing certain about health care right now is uncertainty. Providers are faced with a consistently shifting landscape of "what-if's" surrounding the management of self-pay patients. Among the possible outcomes, changes to Medicaid are almost certain, expected to impact eligibility rules and shrink the number of self-pay patients eligible for coverage.

Identifying a self-pay management approach that's flexible enough to evolve with this uncertainty and ensure efficiency is critical for success. Investing in a software platform to support the program eligibility and enrollment process can deliver unparalleled quality and outcomes.

Providers can expect improvements in several key areas as a result of implementing the right self-pay management software platform. These include:

  • Generating additional reimbursement revenue by identifying more program eligible individuals.
  • Making the overall process of program enrollment more efficient.
  • Lowering the overall administrative cost of the process.

Key Features that Drive Savings

  1. Streamline the Screening Process. The screening process for each assistance program can take several hours. Find a solution that will support screening in just one interview—for both the patient and the patient's family members. This not only saves time but also offers an overall better experience for your patient population.
  2. Reduce Manual Data Entry. Look for a solution that will reduce the need for manual data entry by sharing data across multiple program applications. The patient's information will only have to be entered into the system once, saving time during the application generation process. The data entry burden will be further reduced with the integration of resident healthcare IT systems.
  3. Drive Efficient Re-enrollment Processes. Keeping your patients enrolled in available programs is more efficient than starting from step one each year and provides a greater level of service to the community.
  4. Utilize Self-Service Options to Determine Eligibility Ahead of Time. The initial intake process can be further streamlined with self-service portals that enable patients to complete the screening process prior to a healthcare encounter.
  5. Provide Comprehensive Reporting Capabilities. Comprehensive reporting capabilities eliminate hours spent compiling data to measure productivity and the overall effectiveness of the self-pay process.

In many cases, these improvements can be a challenge to quantify due to the limited or inaccurate information generally available with manual processes. Bluemark has developed a methodology to measure results for its MAPS clients, using a combination of poling, time studies, detailed time recording and reported data analysis. In aggregate, our data shows that the MAPS solution can lower the administrative costs of the eligibility and enrollment process by at least 25% within the first 18 to 24 months of utilization, showcasing the significant value impact on providers.