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Streamlining Financial Clearance to Reduce Imaging Appointment Delays and Enhance Patient Experience

Megan Kalambo^1iD*, Adam Dido², Habib Tannir², George Ninan^2
1Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Clinical Medical Director, Breast Imaging Houston Area Locations, United States
²Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Manager Diagnostic Imaging Operations, DI Outside Image Retrieval Center, United States

Corresponding Author: Megan Kalambo ^{ORCID iD}
Address: Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Clinical Medical Director, Breast Imaging Houston Area Locations, 1155 Pressler, Unit 1350, Houston, Texas 77030, United States.
Received date: 19 May 2025; Accepted date: 07 July 2025; Published date: 15 July 2025

Citation: Kalambo M, Dido A, Tannir H, Ninan G. Streamlining Financial Clearance to Reduce Imaging Appointment Delays and Enhance Patient Experience. J Health Care and Research. 2025 Jul 15;6(2):40-47.

Copyright © 2025 Kalambo M, Dido A, Tannir H, Ninan G. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Patient Wait Times, Financial Clearance, Diagnostic Imaging, Pre‐Authorization, Workflow Improvement

Abstract

Background and Purpose: Lengthy wait times for diagnostic imaging often stem from unresolved financial clearance at check-in, undermining patient experience and operational efficiency. This quality improvement study evaluated a three-part intervention—securing authorization before arrival, proactively flagging accounts lacking authorization, and resolving flagged accounts within one hour of check-in—to reduce lobby delays and improve patient satisfaction.
Methods: We retrospectively analyzed 4,585 patient records from January 2016 through May 2022. Pre-intervention data (February 2016–December 2019) were compared with post-intervention data (January 2020–May 2022). Interventions included: (1) obtaining financial authorization before patients arrived for their appointments, (2) flagging any account lacking authorization so that front-desk staff could immediately engage the Financial Clearance Center (FCC), and (3) targeting same-day clearance within one hour for flagged accounts. Patient Service Coordinators at 11 front desks recorded lobby wait intervals. Statistical analyses and visualizations were conducted using Excel, Minitab, and Tableau; significance was assessed via two-sample t-tests.
Results: Despite a 56 percent rise in imaging volume during the post-intervention period, the average lobby wait time for financial clearance decreased from 61.1 ± 76.3 minutes to 44.1 ± 61.1 minutes (p < 0.0001). The percentage of patients cleared before arrival improved modestly, remaining above 99 percent even amid COVID-19–related FCC staffing shortages. Patients waiting less than 30 minutes for clearance rose from 48.1 percent pre-intervention to 58.2 percent post-intervention, while those waiting over one hour declined by 9.5 percentage points. The number of accounts flagged tripled—from an annual average of ~330 before 2020 to ~1,000 afterward—demonstrating consistent capture of unresolved authorizations without increasing long-wait cases.
Conclusion: Proactive coordination between front-desk staff and the FCC—focused on pre-arrival authorization, systematic flagging, and rapid same-day clearance—significantly reduced lobby wait times, even with increased patient volume and pandemic pressures. Institutions should continue investing in real-time financial clearance workflows to sustain and expand upon these improvements.