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Pricing estimates: Automate your process

Patient Access Weekly Advisor, September 12, 2007

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No matter how often your patient access staff explains the myriad of variables that could affect the bill that the customer must ultimately pay, the customer won't be happy if your ballpark guess winds up nowhere near the ballpark.

In 2006, officials at the Mayo Clinic took proactive steps to mend this process when they realized that their manual approach led to time-consuming and inconsistent estimates.

"We had a significant growth in our self-pay volume, and we have a pretty high degree of folks who come here for a second opinion," says Kelly White, section manager of PFS patient services and special accounts at the Mayo Clinic in Jacksonville, FL.

White helped put together an enterprise team in Jacksonville to develop the following wish list of five qualities they'd like in a software product:

1. Estimates based on historical claim information, not just from the information that the physician provides.
2. The ability to add individual items from its charge description master.
3. Customizable software.
4. The ability to provide the most accurate estimation at that time.
5. Software that could also help facilitate the quality assurance process.

The Jacksonville site implemented the price estimation software in two phases-on the facility side and on the professional side. The trial period lasted three months for each, and Jacksonville went live with the facility piece in April 2006 and the professional piece in January.

The software allows staff to provide an estimate in less than two minutes on the facility side and in five minutes or less on the professional side.

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