SSI Eligibility, Estimation Exceed Expectations at Washington’s Island Hospital
In today’s healthcare landscape, hospitals can’t afford to remain stagnant. It’s a reality Island Hospital of Skagit County, Washington knows well.
In May of 2018, the hospital entered a season of change. With a desire to streamline processes and improve financial performance, the organization began implementation for a new electronic health records (EHR) system and, at the same time, a new patient access solution. Though it was a big undertaking, they were hopeful a concurrent approach would enable them to establish best practices, maximize integration between systems, and enhance their registration and collections processes. And in the end, the transition paid off.
Manual Methods Take a Toll
Before implementing SSI Access Director Eligibility and Estimation, Island Hospital was battling a combination of issues. “…Things were very manual before,” states Bo Gillentine, Manager of Revenue Cycle for Island Hospital. To verify insurance, staff relied on payer websites, each with different web addresses and passwords. And sometimes, a site would go down. Gillentine elaborates, “It was just much more cumbersome and, of course, that makes staff less willing to take those extra steps to go and find the information, so our error rates were higher. I think any time you have more manual processes there is going to be more work, and more errors, involved.” The manual processes also made it difficult to train and retain staff in a field with significant turnover and entry level employees.
In addition to higher error rates, the manual processes resulted in higher bad debt. In 2018, the hospital’s bad debt reached over $2.6 million, while the bad debt figure from January through May of 2019 was below $747,000, and should be significantly lower than 2018 at year’s end.
Unfortunately, the hospital’s inefficient processes impacted their patients, in addition to their staff. “We did have a lot of things that would go through our billing department where things had been turned over for patient responsibility,” said Gillentine. “Then the patients would call upset and they would say, ‘I’ve given you this information already’ or, ‘Why weren’t you able to locate my insurance?’ It would cause a lot of rework, a lot of rebilling.” It was obvious the hospital needed to change their ways.
Island Hospital is a value-driven organization. Their guiding mission, known as the “Island Hospital Promise,” is a promise to patients to put their emotional and medical needs first—and they were searching for a vendor who would put their needs first as well.
The hospital also relied heavily on word of mouth, soliciting feedback directly from users rather than relying strictly on sales representatives. As Gillentine describes, “That was a big deciding factor for us. Some of the companies we looked at didn’t look like they had the ease of use that [SSI] does. Some of them looked a lot more complicated and we wanted to find something that our end-users would really feel comfortable using.”
Following a thorough evaluation, the organization chose SSI and immediately began implementing their Eligibility and Estimation features.
No False Advertising Here
Reflecting on the implementation process, Gillentine is the first to admit she had high expectations for the project. “I’ve worked at numerous hospitals and we’ve never used one tool for insurance verification. …just knowing how manual it was before, I was really excited. I would definitely say that I was more hopeful that everything would work and function as advertised, and it did.”
With about 40 users in the registration department, proper training was a critical component of the implementation process—and SSI didn’t disappoint. As Gillentine describes, SSI’s on-site ‘train the trainer’ session “…was done so well that I could confidently train my staff.”
SSI’s high-touch service didn’t end once implementation was over, however. “You know, the support with SSI was really great—is really great. Whenever we have issues even now, I can send a quick email and get a really fast response,” states Gillentine.
Now that the hospital has been using the system for quite some time, their organization has been transformed, both internally and externally. Wait time for patients is down, as staff is able to verify insurance in advance, rather than at the point of service. The solution’s integration with the hospital’s EHR allows for a seamless, behind-the-scenes verification process. “Our patients don’t have to wait as long and staff don’t have to process as many applications and screens to get that response,” says Gillentine. “Anything to make our patients get through the process faster is always beneficial.” It’s also quicker and easier to identify payer issues.
One item that has proven especially beneficial for the Island Hospital team is the “intelligent guidance” feature within SSI Eligibility. With intelligent guidance, staff are spared from the time-consuming task of searching a response to identify a discrepancy and are instead guided through the appropriate steps to take, with discrepancies pointed out to them. The organization was even able to customize the feature, changing the color of pop-up prompts to red in order to make them stand out more for their team.
Island Hospital’s financial counselors use SSI Estimation tool to determine surgery patients’ out-of-pocket expenses prior to service and develop a plan for payment. While the hospital was using an estimation tool prior to SSI, they have noticed benefits to using estimation and eligibility tools that are all part of the same package. As Gillentine states, “…Our [previous] price estimator didn’t pull any of the data back in—they’d have to verify the benefits, launch into the price estimator, and then input all of those benefit details to get an estimate. It is all integrated now and it pulls that data back, so even the time to run an estimate is much faster and less manual than before.” And time savings wasn’t all that occurred. Gillentine adds, “…I know that our denials have been less, and I can only assume that’s because the errors are less.”
Internal buy-in has made a huge difference for the organization, and could not have been achieved had the software not delivered on its promises. “There’s a comfort level to the system and a trust they have in it that it’s going to give them accurate information. And it’s fast,” states Gillentine. “…we did see some other vendors with products like this and the responses were just as slow as molasses. It took forever. It was almost faster to go out to a different site and get the information. …We get such fast responses when using [SSI] that the staff were really able to buy into the system…”
As Gillentine notes, “At the end of the day, it all boils down to trust in your vendor” and they’re grateful their access team can trust in SSI.