In the ever-evolving world of healthcare, there’s a quiet revolution happening. No, it’s not robots taking over (yet). It’s something much more practical and immediately impactful: pre-visits. Imagine preparing for a dinner party by chopping the veggies, marinating the meat, and setting the table beforehand.
When your guests arrive, you’re not scrambling around like a headless chicken—you’re calm, collected, and ready to enjoy. That’s exactly what pre-visits do for healthcare providers, and the results are just as delicious.
The Shift from Volume to Value: Why Pre-Visits Matter More Than Ever
For decades, the healthcare industry followed the Fee-for-Service (FFS) model, where physicians earned money based on the number of services provided—more tests meant more bills. Over time, the focus shifted to Value-Based Care (VBC), where rewards depend on delivering high-quality care instead of higher volumes.
As one industry expert put it, “You can’t just throw spaghetti at the wall anymore and hope it sticks. You’ve got to serve up a gourmet meal every time.”
This shift has redefined how doctors document care and receive payments. It also forces healthcare practices to rethink strategies, particularly in medical coding and patient engagement. Amid these changes, pre-visits have emerged as a critical tool, enhancing care coordination and patient outcomes in the Value-Based Care era.
What Are Pre-Visits? Think of Them as the Ultimate Prep Work
Pre-visits are all about getting the groundwork done before the patient even sets foot in the clinic. This could mean reviewing their medical history, updating records, gathering lab results, or even having a quick telehealth chat to set the stage for the main event. The idea is to handle all the nitty-gritty stuff in advance, so when the patient arrives, the healthcare team can focus on what really matters: delivering top-notch care.
Why Pre-Visits Are a Game-Changer for Patient Care
Personalized, Proactive Care
In Value-Based Models (VBM) like MIPS, MACRA, and Medicare Advantage, care isn’t just about treating immediate concerns—it’s about anticipating future needs.
Pre-visits equip healthcare providers with the insights needed to customize appointments for each patient. Think of it as a crystal ball, revealing potential issues before they escalate. From monitoring medication interactions to managing chronic conditions, pre-visits help doctors focus on what matters most.
Better Patient Engagement
Engaged patients are more likely to follow treatment plans, attend appointments, and stay healthy. Pre-visits encourage patients to think about their health ahead of time, making them better prepared and more involved in their care. This approach fosters meaningful communication and ensures that appointments are more productive.
Smoother, Faster Appointments
Long waits frustrate patients, and doctors don’t enjoy scrambling through patient histories during visits. Pre-visits streamline the process, reducing waiting time, minimizing stress, and allowing doctors to see more patients efficiently. The result? A better experience for everyone.
The Dollars and Cents: How Pre-Visits Boost Practice Profits
Let’s talk turkey. At the end of the day, healthcare is still a business, and practices need to stay profitable to keep the lights on and the care flowing. Here’s how pre-visits can have a serious impact on the bottom line.
- Maximizing Reimbursement: In the era of VBC, accurate coding is king. According to a 2022 case study by AAPC Services, most practices were losing out on $160,000 annually due to coding errors and insufficient documentation. That’s a lot of cash slipping through the cracks. Pre-visits, supported by skilled Certified Risk Coders (CRCs), help catch these errors before they cost you.
For example, if you’re consistently using a vague code like F32.A for “Depression, Unspecified” when a more specific diagnosis could be coded, you’re leaving money on the table. Pre-visits ensure that your coding is spot-on so you get paid what you’re owed. Pre-visits ensure that your coding is spot-on, so you get paid what you’re owed, as recommended by the American Medical Association.
- Reducing Denials and Penalties: Pre-visits also help prevent the dreaded claim denials and the penalties that come with coding errors. When you’re proactive about reviewing and correcting documentation, you reduce the risk of running afoul of CMS audits or other payer scrutiny. It’s like installing a security system for your revenue—fewer nasty surprises and more consistent cash flow.
- Increasing Patient Volume: When visits are streamlined and efficient, you can see more patients without sacrificing quality. It’s simple math: more patients = more revenue.
But it’s not just about cramming more appointments into the day. Pre-visits make the process smoother, so each patient feels well-cared-for, leading to higher satisfaction, better reviews, and more word-of-mouth referrals. In a competitive market, that’s pure gold.
- Boosting Patient Retention: Happy patients come back, and returning patients are the bread and butter of any practice. When patients see that their healthcare team is prepared, attentive, and efficient, they’re more likely to stick around. And when they stick around, they keep your schedule full and your revenue steady. Key Metrics to Monitor in Revenue Cycle Analytics
Implementing Pre-Visits: It’s Easier Than You Think
So, you’re sold on the idea of pre-visits. But how do you actually make it happen? Here’s a step-by-step guide to getting started.
- Start with the End in Mind: Before you dive in, think about what you want to achieve. Is it better patient outcomes? Fewer coding errors? Higher revenue? Knowing your goals will help you tailor the pre-visit process to meet your specific needs. As Stephen R. Covey famously said, “Begin with the end in mind.”
- Invest in the Right Tools: Technology is your friend here. HCC analytic tools, computer-assisted coding (CAC), and AI-driven solutions can make the pre-visit process much easier and more accurate. These tools can help identify coding gaps, suggest diagnoses, and streamline the entire workflow. And don’t forget about your EMR system—customizing it to include alerts and reminders can keep everyone on the same page.
- Train Your Team: The best technology in the world won’t help if your team doesn’t know how to use it. Invest in training for your coders, clinicians, and administrative staff to ensure everyone understands the importance of pre-visits and knows how to carry them out effectively. This is your chance to create a well-oiled machine that runs smoothly from start to finish.
- Communicate with Physicians: Doctors are busy, and adding more to their plate might not seem appealing. But clear, concise communication can make all the difference. Use tools like EHR messaging or integrated physician queries to share findings from pre-visit reviews without overwhelming the physician. The goal is to provide just enough information to improve care without bogging them down.
- Start Small and Scale Up: You don’t have to implement pre-visits for every patient right away. Start with a small group of providers or a specific type of visit, like annual check-ups, and see how it goes. Once you’ve ironed out the kinks and seen the benefits, you can expand the process to include more patients and more types of visits.
Overcoming the Hurdles: Tackling Challenges Head-On
No good idea comes without its challenges, and pre-visits are no exception. Here are some common obstacles and how to overcome them.
- Finding the Right Staff: Not everyone is cut out for pre-visit reviews. You need staff with the right skills and mindset. This might mean hiring new people or upskilling your current team. It’s an investment, but one that pays off in the long run.
- Time Management: Time is always a challenge in healthcare, but pre-visits can actually save time in the long run. By handling the administrative work upfront, you free up more time during the actual visit. The key is to find a balance—don’t try to review everything weeks in advance, but don’t wait until the last minute either.
- Technology Integration: If your current systems aren’t up to the task, you might need to invest in upgrades or new tools. This can be a tough sell, but demonstrating the financial benefits—like the $160,000 in lost revenue from coding errors—can help get stakeholders on board.
- Getting Buy-In: Change is hard, and getting everyone on board with a new process can be challenging. Focus on the benefits—better patient care, higher revenue, fewer headaches—and involve key stakeholders in the planning process. When people see the value, they’re more likely to support the change.
The Bottom Line: Why Pre-Visits Are a No-Brainer
In today’s healthcare world, where quality matters and every dollar counts, pre-visits are a game-changer. They improve patient care while supporting your bottom line. By preparing for appointments in advance, you can deliver personalized, efficient care, minimize errors, and optimize reimbursements—all without added stress.
Ready to elevate your practice? Embrace the power of pre-visits. They’re not just a helpful tool—they’re the secret ingredient to thriving in the Value-Based Care era. After all, who doesn’t love a little extra sauce on their plate?
