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.

Product Data Sheet

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

  • Eligibility
    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.

Request Demo

Access Management Components

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.

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.

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.

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.

SSI Patient Data Validation reduces input errors by validating and correcting a patient’s name, address, telephone number and other demographic information in real time, at any point in the revenue cycle. Accessing multiple demographic data sources, patient information is returned to the registrar, highlighting differences and allowing them to take appropriate action, as defined by the organization’s business rules. The solution eliminates the need to move outside of the registration system, which allows patient access staff to continue to process patients during the validation process.

With SSI Patient Data Validation, your organization can:

  • Prevent input errors
  • Reduce returned mail and time spent resending correspondence
  • Minimize patient identity-related denials
  • Eliminate the need to manually update patient data
  • Maintain address standardization within the information system’s master patient record

Request Demo

Request Demo

Interested in what SSI can do for you?

Copyright© 2019 The SSI Group, LLC All rights reserved