Accelerate Reimbursement and Optimize Revenue at Patient Access
As patients increasingly bear the financial burden of healthcare costs, providers need access to timely and accurate insurance eligibility verification and details about coverage and co-pays.
Additionally, hospitals need tools to help them estimate patient bills, validate patient identity, assess a patient’s propensity to pay, and manage pre-authorizations/medical necessity—at or before the point of service.
How do you know if the insurance information you have about a patient is complete and accurate? And how can you make it as easy as possible for patients to pay for the care they’ve received?
The value of RelayClearance Plus begins at registration, providing accurate data for your downstream processes.
With RelayClearance Plus, you can efficiently increase registration data accuracy, complete insurance eligibility verification, automate pre-authorization screening and verification, estimate patients’ financial responsibility, accept point-of-service collections, validate patients’ identity, and help patients who are unable to pay look into financial assistance programs.
Key Capabilities and Benefits:
Helps Improve Registration Data Accuracy. Your patient access and registration staff are challenged by many factors — a changing healthcare environment, variable insurance coverage, mandates to improve customer service — while still needing to register patients quickly and accurately. RelayClearance Plus helps identify errors at registration to provide accurate data for your downstream processes. Improved data accuracy may help lead to reduced denials, a smaller number of returned statements and fewer rejected claims so you can optimize your cash flow and A/R days.
Verifies Insurance Eligibility. RelayClearance Plus allows you to perform unlimited insurance eligibility verification throughout the entire healthcare revenue cycle and at every patient encounter. We understand that if you can submit third party payment information whenever necessary, it will help you prevent claim denials and future re-work and improve your cash flow.
Manages Pre-Authorization & Medical Necessity Workflow. RelayClearance Plus helps manage the cumbersome and time consuming pre-authorization and medical necessity processes. The solution determines if a pre-authorization is required and on file with the payer, monitors payers for pending pre-authorization decisions and updates the HIS/Practice Management system with payer results. It also provides a consistent workflow to manage both automatic and manual pre-authorization processes. RelayClearance Plus also assists with the checking of medical necessity and automatic creation of necessary ABNs, helping reduce denials, improving reimbursements, and ensuring compliance with CMS guidelines.
Screens Patients’ Propensity to Pay and for Charity Care and Financial Assistance. We recognize that you want to provide the best care possible to each and every one of your patients, regardless of their financial situation. RelayClearance Plus helps you by automatically screening patients’ ability and inclination to pay. Healthcare payment prediction scores let your staff assess whether or not a patient might pay and when. Furthermore, our solution alerts you to patients who are unable to pay and should be counseled about charitable options, Medicaid, or other financial assistance. An online screening interview and enrollment form are included in the registration workflow so your staff can easily integrate this step when appropriate.
Provides Patient Bill Estimates and Simplifies POS Collections. RelayClearance Plus helps patients prepare for their upcoming procedures by calculating pre-service bill estimates. These estimates set patients’ financial expectations beforehand, increasing the likelihood that you’ll be able to effectively collect payment. RelayClearance Plus assesses each patient’s financial circumstance and creates a recommended point-of-service deposit. It allows registrars to accept payments via cash, paper check, or credit and debit cards using a PCI (payment card industry) compliant payment service. Any payment you receive can be automatically posted to the HIS, eliminating duplicate data entry.
Validates Patients’ Identities. Our solution helps you detect possible fraud and identity theft. RelayClearance Plus verifies that each patient’s demographic data is correct and notifies you about patient data issues or red flag alerts that could be related to identity theft. It also helps you find the patient’s best address.
Helps Improve Patient Flow and Satisfaction. For most hospitals, the Registration or Admissions Office gives patients their first impression of the entire organization. Delayed registration wait times may increase anxiety about the patient’s upcoming procedure, which can negatively impact patient satisfaction ratings. Beginning with a paperless sign-in, RelayClearance Plus helps put patients at ease, and helps alleviate long wait times by assisting in discovering and averting bottlenecks in your service delivery areas.