825 Spotlight: Methodist Physicians Clinic Pre-Access

In an effort to highlight the work of teams behind the scenes, every other month we'll be featuring an 825 Building department in a series called “825 Spotlight.” The work of these departments plays an important role in our mission and in The Meaning of Care. With each update, we'll shed light on a specific function and the amazing teams that drive its work.

The Methodist Physicians Clinic Pre-Access team supports the patient by ensuring that their financial health is also well taken care of during their journey within Methodist Health System. The team makes sure the patient’s insurance information is accurate, confirming that scheduled services are a covered benefit of their plan. Further, it verifies that those services meet the medical necessity requirements of the patient’s insurance policy and obtain an authorization if required. Pre-Access works alongside clinical partners and other revenue cycle teams within the system to provide The Meaning of Care for the patient. 

The team's work connects to the Methodist mission in many ways. Pre-Access cares by working tirelessly to meet insurance company requirements so patients don't have to worry about unknown costs; it educates clinical partners on insurance medical necessity requirements; and it is constantly innovating process improvement by continuously evaluating how processes are performed to ensure that goals are met and high-quality work is being produced. Pre-Access is looking forward to the next phase of growth as a team – Continuing to tackle insurance company demands on Methodist facilities while caring for patients' health. 

While the team provides a large depth of authorizations, it doesn't perform all authorizations for the system. Its focus is on the highest dollar services performed within Methodist facilities, including, but not limited to, surgeries, procedures, infusions, radiation therapy, imaging exams and other diagnostic tests or therapies. 

If Pre-Access does its job well, patients and providers have a seamless transition from when services are scheduled to when they are performed. Pre-Access is the silent partner in the health system.

"I am most proud of our team’s endless dedication to our work. Each team member is committed to our patient’s needs first. Having this focus in our culture, alongside implementing a lean management system, has allowed our team to meet and exceed goals we never dreamed were possible."

- Kelsey Haswell, Senior Director for Pre-Access