Eligibility & Enrollment Services 2023
An Initial Look at Client Satisfaction

Though generally satisfied, organizations that engage a firm for eligibility and enrollment services rarely report exceptional performance. There remains an opportunity for all firms in the market to drive higher satisfaction by improving in consistency of staff quality, frontline staff retention, and fairer and more transparent charging practices.

Elevate Patient Financial Solutions Drives Value with Strong Partnership and Solid Execution

“We have regular meetings with a team from ElevatePFS, and that team stresses the firm’s involvement and engagement to help us work through challenges. The firm is very engaged and shares a monthly dashboard with us where we can see the number of patients they are turning into true applications and true payments, and that is super beneficial. The firm’s reporting is spot-on when it comes to showing us their value.”—Business office director, Elevate Patient Financial Solutions client

Reliability Spurs Loyalty in Change Healthcare Clients; Some Want More Proactive Strategy

“We don’t get very much strategy from Change Healthcare; that comes more from us to them. Change Healthcare does bring in a lot of money for us, but operationally and systematically, there is a lot of room for improvement. We have great things to say about Change Healthcare with regard to eligibility, Medicaid, disability, and all of those good things, but we are working with the firm currently on improving in some other areas. They do good work, but they could be doing great work for us.”—Business office director, Change Healthcare client

Firstsource Turnover Reduces Quality, Detracting from an Otherwise Satisfactory Client Experience

“The firm has had challenges in maintaining employees. Everybody has had this challenge, but there are a couple of markets where we have had significant challenges and significant turnover. We also have trouble recruiting in those markets, so that has stuck out as a pain point. The biggest issue we had continued to happen for a period. When we escalated the issue, the firm came up with an action plan and did all of the things we would expect. They offered incentives and covered with someone remotely from another area. Firstsource handled that well, but we would prefer not to have to escalate things to that level.” —Business office VP, Firstsource client

Additional Industry Insights

Examples of split arrangements used for dividing eligibility and enrollment work between multiple firms include the following: alpha split based on patient name, split by department, split by location, or filtering based on criteria obtained in qualifying questions.

The majority of clients interviewed have eligibility/enrollment staff on-site, though there are no significant differences in satisfaction between those using on-site or off-site staff.

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 12 months using KLAS’ standard quantitative evaluation for healthcare services, which is composed of 9 numeric ratings questions and 3 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into five customer experience pillars—loyalty, operations, relationship, services, and value.

Sample Sizes 

Unless otherwise noted, sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique client organizations interviewed for a given firm or service. However, it should be noted that to allow for the representation of differing perspectives within any one client organization, samples may include surveys from different individuals at the same organization. The table below shows the total number of unique organizations interviewed for each firm or service as well as the total number of individual respondents.

Some respondents choose not to answer particular questions, meaning the sample size for any given firm or service can change from question to question. When the number of unique organization responses for a particular question is less than 10, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 3, no score is shown. Note that when a firm has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.