While backend revenue cycle analytics are often robust, the front end, where patient access processes like prior authorization and registration live, remains alarmingly opaque.
In a recent episode of Infinx Office Hours, Stuart Newsome sat down with Ramona Hernandez to shed light on this critical but under appreciated area. With decades of experience helping hospitals optimize revenue cycle operations, Hernandez offers a timely reminder: “You can’t manage what you can’t measure.”
The Blind Spot in Front-End Revenue Metrics
Most hospitals have well-developed backend analytics tracking accounts receivable and collections. But according to Hernandez, the front end is often still in the dark. “EHRs weren’t built to track metrics like registration accuracy or prior auth cycle times,” she explains. Instead, manual tracking and task-based systems leave access teams without the performance data they need to prevent revenue leakagem, a topic further explored in this webinar on protecting revenue with timely filing safety nets.
When Visibility Fails, Denials Follow
Inefficiencies at the front end often result in canceled appointments, services rendered without authorization, or denials—all of which contribute to revenue loss. Data shows that over 30% of denials originate from front-end access issues, and nearly 80% of prior authorizations are still managed manually. These gaps slow down patient care and increase the risk of write-offs.
Without automated systems or centralized dashboards, health systems miss opportunities to proactively manage the lifecycle of authorizations and registrations.
Why Tracking SLA Compliance Matters
SLAs establish expectations for response times across authorization and verification tasks. Yet many access teams do not monitor SLA compliance across payer types or service lines. This makes it difficult to identify which delays are avoidable and where rework accumulates.
Service lines like imaging, cardiology, and orthopedics are particularly vulnerable due to their authorization-intensive workflows. Monitoring SLA adherence in these areas can significantly reduce denials tied to missed deadlines or incomplete data.
Cultural and Technological Roadblocks
Two major barriers to progress are outdated systems and organizational culture. The front end is often viewed as a basic intake function, rather than a strategic revenue contributor. This perception downplays the importance of registration accuracy, eligibility verification, and authorization tracking.
Compounding this issue, many teams still rely on manual methods—like emails and faxes—to follow up with payers. Without automation, errors go unnoticed until claims fail, and inconsistent processes become normalized.
Turning Metrics into Momentum
Patient access leaders can drive meaningful change by using metrics to advocate for tools, staffing, and training. Dashboards that show rising denial rates or missed SLAs provide concrete evidence for resource investment. This shifts the conversation from anecdotal complaints to data-driven action plans.
In a competitive, margin-sensitive environment, being able to quantify the financial impact of front-end inefficiencies helps secure executive buy-in and accelerate technology adoption.
Patient Access as a Competitive Edge
As healthcare organizations compete on both cost and patient satisfaction, patient access performance is emerging as a key differentiator. Hospitals that treat patient access as a revenue-generating engine—rather than a support function—can reduce delays, improve patient loyalty, and drive better clinical outcomes.
Metrics like prior authorization turnaround time, registration error rates, and payer-specific denial patterns give health systems the insights they need to fine-tune operations and elevate care delivery.
The message is clear: better visibility means better results.
Want to dive deeper into this topic? Watch the webinar on-demand here.