patients are frustrated with the paperwork and concealed pricing structure, and providers have an average collection rate of 60%. Needless to say, all parties involved experienced low satisfaction. Please describe at least four ways you could improve this process flow to reduce errors and improve efficiency.
Here is the image of a medical visit for patients. Our team is looking for improvement in both patient and physician satisfaction. As shown in the image below,
1.patients currently arrive at the medical office and complete an information form.
2. Some patients have appointments, but others are walk-ins.
3. An office assistant places the completed forms in a folder with the patient’s chart while answering the phone, assisting other patients, and dealing with paperwork.
4. The provider pulls the chart, provides the medical service, fills out forms for prescriptions and services provided, and returns it to the front desk.
5. The billing department enters the fee ticket, hopefully without errors, into a claim form to be mailed to the insurance company.
6. The insurance company receives the claim form and checks to see if it was sent to the correct company, if the form was completed correctly by the provider, and if the procedure was covered. If any of the above criteria are not met, the claim is returned to the doctor’s office.
7. If everything is completed correctly, the insurance company mails the medical office a paper check. The check arrives at the front desk where the office assistant can prepare it for deposit or send it to the receivables department for processing, assuming it doesn’t get placed in the “no time to deal with it now” filing cabinet or get thrown away.
8. The patient had no idea how much the services performed would cost so they are shocked when they receive an enormous bill that their insurance has not paid a portion of because they have not yet met their deductible.
This process has so many unnecessary steps and opportunities for errors, patients are frustrated with the paperwork and concealed pricing structure, and providers have an average collection rate of 60%. Needless to say, all parties involved experienced low satisfaction.
Please describe at least four ways you could improve this process flow to reduce errors and improve efficiency.
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