Patient 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 before service

Prior Authorization
Automate PA end to end in just seconds

Admission Notification
Automate the notification process to ensure timely notice of inpatient hospital admittance to payers

Pricing Estimation
Promptly and accurately communicate patient out-of-pocket expenses

Financial Clearance
Increase collections by determining propensity to pay and financial aid eligibility

Payment Processing
Optimize patient payment collection through consumer-focused payment options
Patient access: From afterthought to action item.
Once overlooked, patient access has become a driving force in hospitals. Today, patient access staff have one of the most difficult jobs in the organization. Registrars must be fast and accurate, provide excellent service and collect money for services provided. And in a busy waiting room, it’s hard to consistently accomplish these tasks…and to do so simultaneously.
In many ways, front-end service is a patient’s first impression of a health system. But does your organization have the right tools to deliver?
%
62% of patients said knowing their out-of-pocket expenses before service impacts their likelihood of pursuing care.
Additional Resources
CASE STUDY
How Anderson Regional Revamped the Patient Financial Experience
With the price transparency rule deadline looming, one Mississippi medical center made a bold move to integrate its patient access and patient financial clearance processes to provide greater continuity in financial care.
BLOG
Unwinding Medicaid & the Importance of Eligibility
Medicaid unwinding could lead to the loss of coverage for a substantial number of beneficiaries, potentially impacting up to 15 million people. This scenario puts extra pressure on hospitals to evaluate patients for eligibility for financial aid, charity care, and debt collection efforts.
Access Director,
SSI’s patient access management solution.
Set the tone for a strong revenue cycle and positive patient experience with sophisticated patient 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.
Patient Access Management Components
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.
Whether you’re in the market for access solutions or a single vendor for access through claims, here is the right place to start.
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
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
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.
Insurance Eligibility Verification
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
Pre-Billing Eligibility – SSI also offers Pre-Billing Eligibility Edits, which is a complement to front-end eligibility verification processes and does not replace or conflict with other solutions already in place.
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.
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 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.
Prior Authorization powered by Myndshft
Explore more on Prior Authorization >>
Benefits
- Hospital enterprise-wide solution including home infusion, physical, occupational and speech therapies—anything included under medical benefits
- 700+ real-time payer connections
- Reduces the complexity, costs, and time crunch of a manual process
- End-to-end automation that takes seconds to complete
- Automates necessary data retrieval and attachments
How It Works
SSI Prior Authorization powered by Myndshft first determines if PA is required and sources the appropriate submission form utilizing a proprietary Payer Rules Engine and Policy Library that identifies PA requirements based on the payer, plan, and CPT or HCPCS codes provided. It then pre-screens PA submissions for errors and medical necessity, piping in relevant data including clinical encounter details directly from your system of record using industry-standard HL7 FHIR APIs. Next, the solution submits the PA request directly to the payer with any attachments included. Lastly, the PA request statuses are monitored in one convenient location, with PA approvals returned directly to your system.
Admission Notification
Benefits
- Minimize reimbursement risk and recoup valuable resources by diminishing data entry errors and time spent on notification admissions
- Streamline workflow efficiency by using a single, user-friendly interface for both Eligibility and Admission Notification
- Strengthen compliance with auto-fill capabilities and pending notification worklists
- Automate determination of notification requirements by payer and service type
How It Works
Admission Notification automates the notification process to ensure timely notice of inpatient hospital admittance to payers, creating a more simple and seamless workflow for your access team. On-screen alerts based on payer business rules empower staff to quickly and easily comply with payer requirements and appropriately follow internal protocol. Users can ensure accuracy by pre-filling data, and strengthen compliance with a system-generated worklist of pending admission notifications. Through use of the solution, health systems eliminate the effects of human error, strengthen compliance, and maximize reimbursement efforts.
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
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
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.
Payment Processing
Benefits
- Reduce mail costs and accelerate patient payment
- Improve self-pay and post-insurance payment results
- Increase patient collection rates
- Enhance the patient experience, including the quality of patient statements
How It Works
Payment Processing simplifies the billing process, offering the flexibility required by health systems and patients alike. Integrated with a user’s registration and accounting systems, the solution allows payments to be processed over the phone, online, or in person before, at, or after the time of service. The eBill component provides comprehensive and secure online billing and payment management for hospitals, and accelerates payment by enabling patients to access, and act on, account balances from nearly any electronic device. Hospitals can easily collect copays, remaining balances, and outstanding deductibles, with multiple patient payment options available.
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Make your move toward stronger financial performance.