How Revenue Cycle Technology Got Patients Back to the Office

After experiencing a significant dip in patient volumes during the COVID-19 pandemic, Family Practice Associates of Lexington PSC is now busier than ever.

“Visits probably dropped off 50, maybe 60, percent during the month of April, but started coming back. We've been slammed ever since and really busier than we were pre-COVID at this point,” CEO Craig Gillispie, FACMPE, recently told RevCycleIntelligence.

Ambulatory visits are rebounding from historic lows at the start of the pandemic when many communities were under shelter-in-place orders to minimize the spread of the virus. Some primary care practices have even reported patient volumes at or above baselines rates, according to a recent Commonwealth Fund report.

Family Practice Associates of Lexington PSC is one of those providers. The practice of primary care providers in Central Kentucky has focused on getting patients back to the office when appropriate and delivering care virtually when possible. To help patients know when and how to seek services, the practice has run “health campaigns.”

Health campaigns were emails sent to specific groups of patients that prompted them to take a particular action, for example, reminding them to come in for preventative care.

“The health campaigns were key for sending out [reminders] for the six months that we had missed and to make sure patients came back and got their bloodwork,” said Virginia Burberry, the practice’s director of clinical education.

“There were also a lot of campaigns that went out for physical follow-ups,” added Burberry, who implemented 15 of the health campaigns in a matter of days at the start of the pandemic. “I also did several announcements just stating that we were here, we were following precautions, and it was okay to come in.”

The health campaigns were orchestrated via the practice’s patient intake platform. The platform from health IT company Phreesia includes revenue cycle management and patient engagement applications, including electronic patient financial responsibility payment, which the practice has been using for years.

But the platform has proven to be even more useful during the pandemic. In addition to health campaigns, Family Practice Associates of Lexington PSC has also turned on more revenue cycle management and patient engagement applications to revive patient volumes when they hit new lows in the spring.

Leveraging tools that would keep people out of the waiting room while streamlining new billing workflows was a top priority for the practice, which implemented a telehealth strategy in a matter of days at the start of the pandemic.

“Pre-COVID, we had been talking about telehealth and we had been experimenting with it a little bit,” Gillispie stated. “Normally, something like that we would implement over a couple months. As soon as COVID hit, we implemented in a day.”

The rollout of the telehealth strategy was a little chaotic, Gillispie admitted, but technology turned on to assist workflow changes helped to make implementation successful.

Zero-contact patient intake was one of those changes that was vital to a successful telehealth rollout.

“It allowed patients to get a direct link that sent them directly into the correct provider’s telehealth waiting room, so there wasn't a phone call,” Burberry explained.

Call volumes have been a challenge for the practice since the start of COVID-19. The practice has a clinical support department of 14 people dedicated to managing patient calls, most of which center on scheduling and clinical care advice. Since COVID-19 hit, the team has experienced a consistent 40 percent increase in call volume.

“We've gone from maybe eight or nine people in the queue and on hold to having 35 to 40 people in queue consistently and we just can't keep up,” Gillispie stated.

The zero-contact patient intake has helped to alleviate growing call volumes along with self-scheduling. Leveraging Phreesia’s technology yet again, Family Practice Associates of Lexington PSC installed self-scheduling for patients and changed its hold message to direct patients to the service.

Patients have since used the service, scheduling more than 3,000 appointments by themselves since the practice implemented the feature, Burberry reported. For the practice, this also meant fewer scheduling phone calls for the clinical support department, resulting in greater operational efficiency overall.

And now that technologies like self-scheduling and zero-contact patient intake are up and running, Family Practice Associates of Lexington PSC is not turning back even though telehealth visits have dropped significantly.

“We're leveraging as much as we can,” Gillispie said. “We're actually trying to do more.”

A health campaign, for example, recently went out to address a rising concern for many providers: the upcoming flu season. The campaign reminded patients to get a flu shot and directed them to the practice’s new self-scheduling feature.

In one day, 106 people scheduled an appointment to get a flu shot, Burberry reported.

The practice is also now using patient check-in templates and an added revenue cycle feature that saves billing staff time by showing a breakdown of each patient’s payments in chronological order. The latter also helps billing staff understand what patients owe, which enables more productive communications about patient financial responsibility.

Patient communications are becoming increasingly key to maintaining financial stability in this “new normal.”

Practices are not in the clear just yet, researchers at Commonwealth Fund warned. Providers in emerging COVID-19 hotspots have already seen patient volumes decline once again and the collision of a global pandemic with the upcoming flu season could negatively impact volumes in the near future.

With practices already struggling to recover from devastating volume and revenue losses earlier this year, preparing for a potential second wave of shelter-in-place orders or even a decreased demand for in-person care will be critical to protecting the bottom line.

Technology that engages patients with the revenue cycle early on can help practices like Family Practice Associates of Lexington PSC maintain access to care, even if it is virtual, while increasing operational efficiency.

“It’s really good for the patient, but operationally we're finding that electronic communications help us tremendously, and the less we have to spend on the phone playing phone tag back and forth with patients, the better,” Gillispie stated.