CLIENT

Founded in 1995, Health First is Central Florida’s only fully-integrated health system

with four hospitals, including Holmes Regional Medical Center, Palm Bay Hospital, Cape

Canaveral Hospital, and Viera Hospital as well as seven diagnostic centers. Health First

Health Plans also offers a wide variety of health insurance plan options for Brevard

and Indian River Counties. Health First Medical Group is the largest multi-specialty

physician group on the Space Coast. Health First offers numerous outpatient and

wellness services, including four Pro-Health and Fitness Centers.

CHALLENGE

Like many large multi-facility healthcare organizations, Health First’s patient access

management system was comprised of various nonaligned components. It was

disorganized, inefficient, difficult to use, and prone to error. Patient access – including

appointments, preregistration, and insurance and medical necessity checks – was

coordinated by phone or fax in five separate systems from 25 different access points.

Patient and physician satisfaction suffered from long call wait times, unavailable

schedulers, busy fax lines, or the need to make multiple calls. Faxed physician orders often

resulted in lost, illegible, or inaccurate orders. The system was unable to place patient

reminder calls, costing Health First an estimated $500,000 each year in lost revenue from

no shows. Automated insurance eligibility, medical necessity or authorization checks

could not be made efficiently at the time appointments were scheduled, leading to delays,

reschedules and denials. Employee usage of multiple scheduling and verification systems

led to high staffing levels and expensive ongoing training.

OPPORTUNITY

Director of Patient Access, Michelle Fox, implemented Health First’s patient access

program in 2004 with a vision: Consolidate all 25 access points into one and streamline

all patient pre-arrival services to strengthen Health First’s relationships with patients and

physicians while improving the organization’s bottom line. “I wanted a seamless system

where we can schedule, pre-register, check insurance, obtain authorizations, financially

counsel, collect payment and send an appointment reminder – anything we needed to

do before the patient’s service with one call,” says Fox.

CASE STUDY

HEALTH FIRST OPTIMIZED THE REVENUE CYCLE WITH “ONE CALL

FOR ALL” PATIENT ACCESS

HEALTH FIRSTCENTRAL FLORIDA

4 HOSPITALS (990 BEDS)

7 DIAGNOSTIC CENTERS

1M+ ANNUAL OUTPATIENT VISITS

300+ EMPLOYED PHYSICIAN GROUPS

scisolutions.com 866-472-4338

SOLUTIONPROVIDER NETWORK MANAGERTM AND SCHEDULE MAXIMIZER®

Improve profitability and customer satisfaction with “One Call For All” access management

SOLUTION

Health First implemented the SCI Provider Network Manager and Schedule Maximizer

solutions to help them centralize scheduling and streamline pre-arrival services, making

it easy for their customers – both patients and physicians – to do business with them.

At the same time, they put tools and processes in place to enable proper information for

optimal and appropriate reimbursement to be obtained up front, leading to better working

relationships between clinical and support departments and a stronger bottom line.

Key factors to the success of this new approach are the use of more efficient and

accurate electronic referrals and orders that kick off the scheduling process through

one centralized access point. Scheduling serves as the gatekeeper and can be reached

conveniently by phone, fax, and physician and patient web portals. This team of Patient

Service Representatives assures that specific steps are completed before patient arrival,

including insurance eligibility checks, authorizations as needed, patient pre-registration,

patient financial responsibility counseling, and appointment reminders.

The centralized scheduling department receives thorough training, plus the scheduling

system provides expert guidance, to enable scheduling for a wide range of procedures.

They handle an average of 4,000 calls per week and successfully scheduled more than

195,000 procedures in 12 months. Not only has training time and turnover been reduced,

the entire end-to-end process is much more efficient. Moreover, reimbursement has

increased and Health First is winning market share from the competition with patients and

physicians attracted by the higher level of care coordination their centralized scheduling

team provides.

OUTCOMES

• Upfront collections increased 25% overall and 100% in the first month due to

automatic reminder calls

• Approximately $1M/month is collected at time of service

• Reduced FTEs by 15.6% by reallocating them to other duties, resulting in annual

savings of $150K

• Reduced training time by 75%

• Reduced call volume by 20% using self-service tools

scisolutions.com 866-472-4338

“SCI products enabled Health First to

make access easy for our patients and

our physicians while also increasing

efficiencies for our front end revenue

cycle staff.”

—Michelle Fox Director Patient Access

Health First

“The SCI data analytics tools make it very

easy to identify trends in physician and

group utilization.”

—Joe Imbruglio Manager of Revenue Operations

Health First

ABOUT SCI SOLUTIONS: SCI Solutions improves the health of the healthcare system by enabling provider networks to gain economic value and improved physician and patient satisfaction through better community-based care coordination. SCI operates a cloud-based service used by more than 12,000 physician practices and 800 hospitals, health systems and imaging centers in 300 markets across the U.S. to coordinate patient care transitions, obtain insurance authorizations, schedule patients, automate referrals and manage orders.

scisolutions.com 866-472-4338