Access Management

Making the front-end your first priority.

Integrated front-end solutions to improve patient financial experience and revenue cycle results.

{ Hover over each component to learn more }

Address Validation

Determine address deliverability, minimizing returned mail and unpaid invoices

ID Validation

Reduce input errors by confirming patient identity and demographic information

Eligibility

Verify patient insurance eligibility at the point of service

Medical Necessity

Maximize revenue and regulatory compliance by verifying medical necessity pre-service

Estimation

Promptly and accurately communicate patient out-of-pocket expenses

Financial Clearance

Increase collections by determining propensity to pay and financial aid eligibility

Patient access staff are plagued with challenges.

Patient financial responsibility is on the rise, causing today’s patients to demand greater transparency and trust from healthcare providers. Your patient access staff have one of the most difficult jobs in the hospital. Registrars must be fast and accurate, provide excellent service and collect money for the services you provide. And in a busy waiting room, it’s hard to consistently accomplish these tasks…and to do so simultaneously.

Patients are now the payer. Patient liability is the third largest payer behind Medicare and Medicaid.

Access Director,
SSI’s access management solution.

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.

Access Management Components

À la carte or the full suite of offerings, build the package to suit your needs.

Our flexible platform provides a powerful synergy of integrated information from multiple verification sources, combined with intelligent guidance that enables staff to reduce costly registration and collection errors.

Address Validation

Benefits

  • Confirm address deliverability and maintain the correct USPS Coding Accuracy Support System (CASS) standard format
  • Correct address discrepancies while the patient is present
  • Reduce volume of returned mail and unpaid invoices
  • Maintain address standardization within the information system’s master patient record
How It Works

Incorrect addresses can lead to an influx of returned mail and unpaid invoices, taking a toll on your revenue cycle. Not to mention, reworking undeliverable billing statements is costly, especially when you’re using valuable resources that could be allocated to other priorities. That’s why it’s imperative for registrars to validate addresses prior to, or at, the point of service.

Address Validation enables health systems to determine address deliverability in real-time, at any point in the revenue cycle. Accessing the USPS Address Matching System and other critical sources, the most accurate information available is returned to the registrar, helping eliminate payment delays and issues with patient communications.

ID Validation

Benefits

  • Minimize patient identity-related denials
  • Identify potential fraud
  • Confirm current address and length of use (information that can be used to confirm program eligibility like Medicaid or county programs)
  • Identify additional addresses, secondary residences, and phone numbers
How It Works

Inaccurate demographic information causes claims to be rejected and can lead to potential HIPAA violations. In order to protect your organization, it’s critical to confirm a patient’s identity before providing service.

ID Validation reduces input errors by confirming a patient’s / guarantor’s identity, and obtaining updated demographic information, along with current address and phone number. The solution authenticates identity by linking individuals to their name, social security number, date of birth, and any current or former address, without requiring a credit check. This information is used to highlight differences and guide staff’s follow-up action according to your organization’s business rules. With ID Validation, front-line staff are empowered with current information and enabled to ask the right questions, while still engaged with the patient—without requiring patient permission to verify.

Eligibility

Benefits

  • 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

Without real-time verification while the patient is present, you’re not equipped to confirm patients’ coverage and primary insurance plan. Eligibility enables providers to verify patient insurance coverage and service-specific benefits to allow for successful pre-service payment collection. Immediate, automatic, and real-time, the solution maximizes collections and allows registrars to devote more time to other registration duties.

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.

Medical Necessity

Benefits

  • 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 cause claim rejections. The tool helps determine whether a Medicare service is medically necessary to help ensure the provider receives payment. If a service is not reimbursable, it provides registrars with an ABN for the patient including the potential patient financial obligation, which protects against unexpected liability for charges, allegations of Medicare fraud and potential fines for billing of uncovered services.

Estimation

Benefits

  • 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.

Financial Clearance

Benefits

  • 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.