Category: Revenue Cycle

Adjudication | Where The Purchase Funnel and Medical Practice Meets

Every marketer is familiar with the purchase funnel: Awareness → Consideration → Research → Purchase. It turns out this same framework maps almost perfectly onto the medical practice revenue cycle — and understanding that alignment helps diagnose exactly where revenue is leaking.

## Stage 1: Awareness — Clear Financial Policy

The first stage in the funnel is the patient becoming aware of their financial responsibility. This happens before any service is rendered, and it is largely driven by your front desk team.

A clear, written financial policy that is reviewed and signed by every new patient establishes expectations early. Patients who understand their copay, deductible, and billing process are more likely to pay — and less likely to dispute balances later.

**Where practices fail:** Relying on verbal-only communication, or skipping the financial policy conversation entirely during busy check-in periods.

## Stage 2: Consideration — Accurate Demographic Data

Just as a consumer considers a purchase by gathering information, your billing team needs accurate data to process a claim. This is the demographic and insurance verification stage.

Front desk staff must collect:
– Full legal name and date of birth
– Current insurance card (front and back)
– Primary and secondary insurance if applicable
– Correct referring provider if required by the plan

**Where practices fail:** Outdated insurance information in the system, or staff who skip verification for returning patients because “we have them in the system.”

## Stage 3: Research — Eligibility and Insurance Verification

Before the consumer commits, they research. In your revenue cycle, this is eligibility verification — confirming that the patient’s insurance is active, the provider is in-network, and the patient’s specific plan covers the service.

Running eligibility checks the day before (or morning of) each appointment catches:
– Lapsed coverage
– Changed plans
– Out-of-network scenarios
– Pre-authorization requirements

**Where practices fail:** Assuming prior eligibility verifications are still valid, or skipping verification for established patients.

## Stage 4: Purchase — Claim Filing

The conversion point. In the purchase funnel, this is where money changes hands. In your revenue cycle, it is the submission of a clean claim.

Time is money here. The longer the gap between date of service and date of claim submission, the longer it takes to collect — and the higher the risk of timely filing denials.

MedLink’s standard: **Claims submitted within 48 hours of service.**

## The Post-Purchase: Patient Collections

One area the classic funnel misses is the post-claim patient balance. After insurance pays, the remaining patient responsibility must be collected. The research is clear:

– **Collecting at time of service is 6x more effective** than billing after the visit
– Text and email payment reminders significantly outperform paper statements
– Practices that communicate expected patient balances at check-in collect more, with fewer disputes

## Putting It Together

The practices with the healthiest revenue cycles treat every step of the process with intentionality — from the financial policy conversation at check-in to the 48-hour claim filing standard to the patient balance follow-up process.

If any stage in your funnel is broken, revenue leaks. If you want to identify where your funnel has gaps, reach out for a free revenue cycle assessment.