Cancellations of medical and surgical appointments can create significant disruptions in healthcare settings, leading to lost revenue and decreased patient satisfaction. One effective strategy to mitigate these cancellations is to ensure that all appointments are financially cleared at least three days before the scheduled date of service. This approach not only improves operational efficiency but also enhances the patient experience by allowing adequate time for patients to prepare for their appointments. In this article, we explore the benefits of early financial clearance based on firsthand experience and industry best practices.
The Importance of Financial Clearance in Reducing Cancellations
1. Enhancing Patient Satisfaction
Financial clearance is a critical step in preparing patients for their medical or surgical appointments. Clearing patients at least three days in advance allows them to address various logistical concerns, such as arranging payment for estimated out-of-pocket costs, taking time off work, finding childcare, and securing transportation. For patients who experience high anxiety regarding their upcoming procedures, having ample time to understand and confirm their financial responsibilities can significantly reduce stress.
Early financial clearance also gives patients the opportunity to participate actively in the process, such as by contacting their insurance companies or doctors to expedite authorization. This involvement can help ensure that all necessary paperwork and approvals are in place, preventing last-minute cancellations due to incomplete financial arrangements. Involving patients in this way by the five-day mark allows them to assist in securing the appointment, providing a buffer to ensure financial readiness three days prior to the service date.
2. Securing Revenue and Maintaining a Full Schedule
From a financial perspective, clearing appointments in advance is crucial for revenue management. If financial clearance is delayed until the day before the appointment, there is often insufficient time to fill the slot with another patient if the original appointment is canceled. By resolving all financial matters at least three days in advance, healthcare providers can minimize the risk of last-minute cancellations, maintain a full schedule, and optimize both revenue and resource utilization.
3. Freeing Up Pre-Access Staff for Urgent Needs
For hospital settings, where the Pre-Access team is responsible for financial clearance, managing scheduled appointments in advance is crucial. When routine appointments are cleared ahead of time, it frees up the Pre-Access staff to focus on STAT and add-on tests or surgeries. These cases are highly sensitive due to their medical urgency and the potential for significant revenue loss if services are rendered without financial clearance.
By handling routine appointments well in advance, the Pre-Access team can dedicate their attention to urgent cases as they arise, ensuring that these patients receive timely and efficient financial clearance. This reduces the risk of revenue loss from services performed without proper financial authorization and improves overall patient throughput, particularly for those with critical medical needs.
4. Physician and Surgeon Satisfaction
Early financial clearance is also a significant satisfier for physicians and surgeons. When a patient’s scheduled follow-up appointment to review test results performed at the hospital is canceled or rescheduled due to lack of financial clearance, it can disrupt the physician’s schedule, necessitating a rescheduling of the visit. This inconvenience can lead to frustration for both the physician and the patient, especially when timely communication of results is critical.
Surgeons, in particular, appreciate knowing in advance if a surgery has not been authorized. If financial clearance is not obtained and the surgery proceeds without prior authorization, it could mean performing the surgery without payment. Surgeons have expressed gratitude when informed of potential issues with authorization, as they prefer to avoid the situation of performing a surgery without compensation. Additionally, many surgeons are willing to personally get involved to help expedite financial clearance if delaying the surgery could harm the patient. This proactive involvement ensures that both patient care and physician resources are optimally managed, aligning financial and clinical considerations
5. Expedited Patient Check-In Process
Another significant benefit of early financial clearance is the expedited check-in process for patients on the day of their appointment. When all services are pre-cleared, patients can move through check-in more quickly, reducing wait times and enhancing the overall patient experience. This efficiency is especially important in a hospital setting, where delays can cascade and impact multiple departments and services. By streamlining the check-in process, healthcare providers can improve patient flow and reduce stress for both patients and staff.
Conclusion
Reducing cancellations in healthcare requires a multifaceted approach, but one of the most effective strategies is to ensure early financial clearance for all medical and surgical appointments. By clearing appointments at least three days in advance, healthcare providers can enhance patient satisfaction, secure revenue, maintain a full schedule, manage urgent cases more effectively, and improve physician and surgeon satisfaction. Implementing this practice is not only beneficial for patients but also crucial for the overall efficiency and financial health of healthcare organizations.
By prioritizing financial clearance and involving patients in the process, healthcare providers can foster a more organized, patient-centered approach to care, ultimately leading to better outcomes for everyone involved.
Author: Yvonne Griesman, Director Consulting Services, Healthrise.
Ready to improve your revenue? Contact Healthrise and schedule an assessment today!
