Integrated front-end solutions to improve patient financial experience and revenue cycle results.
SSI Access Director
Set the tone for a strong revenue cycle and positive patient experience with sophisticated access management tools that integrate with your existing hospital systems. SSI’s access management platform, Access Director, helps relieve the burden of complicated registration and collections processes, allowing front-line staff to focus on patients rather than policies. Health systems use Access Director to reduce registration errors, maximize collections, and squash the main sources of revenue leakage at their organizations. And, with more automation and information, they can deliver accurate financial information to patients for increased engagement and dialogue.
SSI Access Director provides real-time, actionable information that guides users through the most effective collections approach, based on patients’ unique financial circumstances. Customized workflow guidance helps simplify complex patient access processes, reduce rework, and increase and accelerate revenue. As the industry moves to be more patient experience focused, the solution ultimately enables providers to focus on patients instead of policies.
Access Director Features & Functions
As healthcare consumers increasingly adopt high-deductible health plans and move between plans at an increasingly high rate, it is imperative for providers to verify patient eligibility and secure their ability to receive prompt payment prior to care. SSI Eligibility enables providers to verify patient insurance coverage and benefits to allow for successful pre-service payment collection. Patient access users can easily and intuitively master the complex registration and collection process via on-screen cues that guide patient interactions and decisions. Using SSI Eligibility, organizations can verify eligibility for every patient, every time, within seconds – and improve their processes and cash flow as a result.
- Medical Necessity
Pre-service verification of medical necessity helps providers develop a strong defense for reducing denials and ensuring compliance with Medicare’s Advance Beneficiary Notice (ABN) requirements. With SSI Medical Necessity, providers can determine the correct codes to validate medical necessity and issue Advanced Beneficiary Notices (ABNs) prior to service. Equipped with this checks and balances system, organizations are enabled to reduce the risk of lost revenue and non-compliance, while clarifying patients’ rights and financial obligations prior to service.
Access Management Components
- Reduce claim rejections through identification and remediation of insurance issues
- Simplify and maximize point-of-service collections by easily – and immediately – collecting patient co-pays and deductibles
- Identify unknown Medicaid and commercial insurance coverage for self-pay patients
- Automatically identify and collect on retroactive insurance coverage
How It Works
In a perfect world, registration staff would obtain accurate information and verify insurance coverage for every patient, every time. But how do you ensure you are achieving this objective? Access Director Eligibility integrates with your EMR to initiate a real-time eligibility inquiry during the registration process, as soon as necessary data elements are entered, and returns an easy-to-understand 271 customized response based on the services the patient is at your facility to receive.
- Prepare patients to pay with pre-service estimates
- Significantly increase point-of-service collections
- Reduce days in A/R for patient out-of-pocket responsibility
- Increase price transparency and keep up with price transparency requirements
- Minimize patients’ anxiety about financial obligations
- Identify and arrange payment options prior to service, based on estimated cost and ability to pay
How It Works
Recent legislation has called for providers to establish greater price transparency with patients, who are commonly more likely to pay when they understand their monetary obligations. With Estimation, health systems can determine patients’ estimated out-of-pocket expenses and payment possibilities through a pre-service cost estimation process and effectively communicate these items to the patient.
SSI Estimation applies intelligent logic by calculating procedural charges, analyzing historical data, evaluating contract pricing between your organization and the payer, and applying patient benefit information to establish the patient’s estimated financial obligation at the earliest point of contact. Automated intelligent guidance directs the complex discussion of the patient’s financial obligation via customized scripting, allowing staff to provide consistent messaging and improve the patient’s experience.
- Create, deploy and manage payment policies consistently across your entire revenue cycle
- Access key predictive scores for patients, in addition to household income and financial burdens
- Establish appropriate payment plans
- Screen for Financial Aid eligibility
- Strengthen collections efforts
- Eliminate open accounts
How It Works
With bad debt and collection costs on the rise, it’s important to be proactive in identifying a patient’s propensity to pay and acting on it at the point of service. In order to do so, hospitals and health systems need accurate information regarding patients’ financial situations and the ability to use it to develop flexible payment options.
SSI Financial Clearance helps increase collections, both up-front and over time, by providing the guarantor’s propensity to pay while simultaneously notifying registrars of potential financial aid or charity care eligibility. Armed with accurate patient financial information, health systems can then customize individual payment programs to align payment policies and patients’ payment capabilities.
- Decrease medical necessity denials and unnecessary write-offs
- Reduce the need for Advanced Beneficiary Notices
- Improve regulatory compliance
- Enhance patient satisfaction by clarifying patients’ rights and obligations prior to service
How It Works
Medical necessity accuracy is critical to successful registration. With Access Director Medical Necessity, determine the correct codes to validate medical necessity and issue Advanced Beneficiary Notices (ABNs) prior to service, thus reducing the risk of lost revenue and non-compliance.
Medical Necessity provides the front-end solution to quickly and easily check diagnoses and procedures against Medicare LCD & NCD rules, along with OCE and CCI edits that can cau