Patient Access and the Revenue Cycle

patient access and revenue cycle healthcare

The billing and collection staff in most healthcare organizations often suffer the highest rate of turnover, yet they are imperative to the continued operation of your business. These staff members, sometimes called the patient access staff, don’t always have the opportunity to develop meaningful relationships with your patients or interact in any way other than asking for payment.

It’s likely a safe assumption that most patients understand that they will have to pay for the services and care they receive. But imagine, just for a moment, that you are the patient and your physician told you that you have a cancerous tumor that has spread. What are you thinking about? Living or paying your $20 co-pay?

This is the type of environment your patient access staff works in. They are looking at ICD-10 codes, attached to an account number, which is attached to a name, but they don’t have the opportunity to know the person at the other end of the name. They’re adding a straw to the camel’s back, maybe even the final straw. It’s no wonder the turnover is high.

The healthcare environment is constantly changing and with that change brings higher patient responsibility (which translates into a bigger straw on the camel’s back). As an organization, you must adapt and be the “face” change. Regardless of your generation, it is imperative to recognize the importance of technology and the role it plays in the revenue cycle process. Analyze your organizational and patient needs and adapt the processes that will make you the most efficient.

My chiropractor uses technology quite well and at a low cost to his one doc shop. Prior to a patient’s first appointment, his front end staff person verifies the benefits and communicates clearly to the patient what their responsibility will be at that first appointment. If a deductible is present and unmet, this person explains what the cost will be, as well as subsequent office visits until all deductibles are fulfilled. An automated appointment reminder is sent out 24 hours in advance, I opt in for a text message that allows me to create an appointment on my calendar if I forgot to do so at the office. Within the message, you will find all the information needed to cancel the appointment if necessary. At the visit, all fees are collected before you see the doctor and you can have your receipt emailed, texted or printed out. Automating the patient intake and billing process, allows his office staff to connect to patients on a more personal level when they arrive. They also have very few missed appointments or the need to collect on patient balances.

What are the steps you can take to automate and create a smooth revenue cycle?

  • Set a positive tone for the entire patient experience
  • Complete the patient financial clearance process correctly
  • Collect appropriate monies due at the time of service
  • Assure that patients get to the right place with the right provider at the right time
  • Find a third party vendor that can automate your needs
  • Educate your staff on patient engagement and collections


Baylor All Saints of Fort Worth creates a career ladder approach for their revenue cycle (or patient access) staff. An employee starts by working in the support staff services, accessing data for management and all staff members. From that point, they progress into billing and balance adjudication or payment and adjustment posting. That position moves into the collections department, with a clear understanding of intake and billing, as well as patient payment expectations. The collections position, allows the staff member to work into contract compliance, transplant claims adjudication and customer service. Once this final step of the ladder is achieved, this same person can progress into management or director positions.* Baylor makes a position that many consider a dead end into a jumping off point, creating an employee that is well-versed in the revenue cycle process.

Your front line staff is the face of your business and your billing and collection staff is the last memory. What picture are they painting of you?

*Source: Strategies for a High Performance Revenue Cycle, HFMA