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Patient Access

Patient Access Product Sheet

With the downward pressure on reimbursements and more financial responsibility falling to patients, the importance of determining coverage and benefits in advance has never been more vital to profitability.

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Providers’ fiscal wellbeing, like physical health, is all about taking proactive measures.

The more healthcare providers know about a patient’s coverage and benefits in advance of care delivery, the more likely full and prompt reimbursement is realized. This is particularly true in an era of increased patient responsibility. SCALE®Patient Access is an integrated RCM technology solution comprised of four efficiency-enhancing front-end transactions: Flex270, real-time patient eligibility; Prior Authorization; Notice of Admissions; and Patient Identity/Address Verification.

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Flex 270

Verify patient coverage and benefits in real-time with greater flexibility and accuracy.

A high-quality, timely eligibility request and response at the time of registration goes a long way toward ensuring a profitable patient episode. Not to mention tightening the revenue cycle by reducing A/R days and preventing denials on the backend. H.IP’s flexible real-time patient eligibility product may be integrated with patient registration systems or accessed independently via a web-based interface.

  • Comprehensive array of patient coverage and benefit data, including PCP & Specialist co-pay, deductible, service type, inpatient days, and more
  • Even after registration, other existing coverage may be detected
  • Payer configuration for eligibility requests is extremely flexible and managed by H.IP on your behalf
  • Analytics on 271 eligibility responses based on your payers’ functionality
  • H.IP develops customized implementation plans, including Payer ID mapping

Prior Authorization/Pre-Certification

Know in advance coverage limitations and payer responsibility through a real-time transaction.

Obtaining prior authorization/pre-certification for procedures is easier than you may realize with H.IP. We automate the transaction and integrate it into your workflow. Easy and uncomplicated, it’s real-time information about payment responsibility based on payer rule. Saves A/R days and help avoid misunderstanding with patients in an era where they’re responsible for larger percentages of compensation.

  • An integrated solution providing real-time 278 responses for payers who support them
  • For payers who do not support the automated, electronic request, H.IP provides payer forms for fax submission to create a trackable, actionable workflow

Patient Identity/Address Verification

Transcend basic address verification with more thorough identification and authentication.

Don’t play the I didn’t receive the bill cat-and-mouse game. Know with certainty the patient will receive your correspondence through an enhanced level of address verification accuracy. H.IP leverages proven effective third-party resources to confirm residence via several data points.

  • Solution integrated with other components of Patient Access product
  • Be confident in patient’s address with substantiating demographics

Notice of Admission

Automate Notice of Admission submissions into current workflow seamlessly.

The prompt delivery of accurate inpatient NOAs is a responsibility more and more payers require. H.IP can automate and streamline the process electronically through our integrated solution, while insulating your facility from potential revenue loss and preventing unnecessary payer frustration.

  • Automated solution that is easily integrated and customized for providers
  • Any changes in payer NOA policies are managed and updated by H.IP