KLAS: Healthcare Orgs Satisfied with Eligibility, Enrollment Services

Healthcare organizations are generally satisfied with their vendor partners that provide eligibility and enrollment services, but there is room for firms to improve their staff quality, charging practices, and partnerships with clients, according to a KLAS report.

As costs rise and workforce shortages persist, healthcare organizations may outsource eligibility and enrollment services to help connect uninsured patients with coverage. These services allow organizations to gain outside expertise on government programs and eligibility requirement changes.

The KLAS report surveyed client organizations to determine their satisfaction with firms that provide eligibility and enrollment services.

Elevate Patient Financial Solutions (ElevatePFS) received the highest overall performance score of 87.5 on a 100-point scale. Most organizations that utilized ElevatePFS for eligibility and enrollment services said that the vendor goes above and beyond as a strategic partner.

Clients were satisfied with the vendor’s effective communication and timely responses. They said executives are willing to help with issues and that the frontline staff has strong expertise. ElevatePFS received the top ratings for strength of partnership and quality of execution.

Some respondents noted that the firm charges for every little thing. But clients also cited how the firm uses its dashboard and detailed reports to help clients understand the improvements, outcomes, and value of the changes. Therefore, clients had high satisfaction with getting their money’s worth.

Change Healthcare received a performance score of 85.6. Most clients are generally satisfied with the firm, citing its subject matter expertise, consistent communication, good customer service and follow-up, and helpful staff.

The less satisfied respondents said they want the firm to be more proactive and provide a more collaborative partnership. Additionally, clients want the firm to be more strategic with its operations and more forward-thinking in helping organizations be financial advocates for patients.

The final vendor included in the report was Firstsource, which received a performance score of 82. Satisfied clients reported that the firm’s day-to-day execution is good and the executive team is responsive.

Around 70 percent of respondents were satisfied with Firstsource’s staff retention, but clients mentioned turnover more often than clients of other firms. Organizations said that the frequent turnover leads to inconsistent expertise, weak follow-through, and poor problem-solving skills from frontline staff.

According to respondents, the firm quickly responds to these issues and develops solutions when problems escalate, but clients said they wish they didn’t have to resort to escalation.