Are physician offices saying great things about access?
Patient access managers worry a lot about how satisfied patients are with their services, but physician offices are another type of "customer" that requires attention. Cheri S. Kane, MSA, FHFMA, CHFP, FACMPE, division president of The Outsource Group in St. Louis and former vice president of revenue cycle at Grady Memorial Hospital in Atlanta, says that "communication, communication, communication" is the key.
"A hospital's physicians are key to assuring the hospital's success. Failed communication will create dissatisfaction between the patients and the physician's office team," says Kane.
This can cause problems with everything from the patient's admission status to loss of funds due to lack of pre-authorizations. "It is important to ask physicians and their staff what the issues are, and work to address the issues by developing new processes," says Kane. "If the physician's staff are pleased with the communication from the hospital, the physician will be also."
Give a single point of contact
Dee Sutton, manager of central scheduling and concierge services at Bon Secours Hampton Roads Health System in Portsmouth, VA, says that her department now gives physician practices the option of being assigned a concierge. That individual is responsible for scheduling, registration, insurance verification, and obtaining authorization if needed.
Previously, the doctor's office had to contact scheduling, then a registrar would contact the patient, and ultimately, the doctor's office was responsible for tying up any loose ends. "It's definitely been a successful program. The physicians love it because they have one contact person," says Sutton. "This provides a 'one and done' opportunity to our physician practices."
The concierge also follows up to make sure that the physician got the report, and makes sure that the physician's office sends over any clinical records that are necessary.
Sutton says that while most practices can benefit from this service, "there are still some practices out there which like to have their hands in the scheduling and authorization process. Concierge is not ideal for those practices."
Those practices still call in their own scheduling and hand off the process to registration, which contacts the patient. "From there, it goes to the insurance verification teams, who verify the benefits and that the authorization is performed. And sometimes it's still up to the physician practice to do that," says Sutton. "We still follow up to make sure that the patients came in, and if a patient didn't show, we do follow-up on those. We still provide that authorization service the standard way if it is requested by the practice."
A committee process is used to determine whether a given practice would benefit from the concierge program. "If a practice reaches out to us and says they are interested, then we pull up information on that practice," says Sutton. "A committee then decides whether or not it's a good practice for this, considering many factors."
Once practices are using the concierge system, however, Sutton says "they are very happy. Once they are on it, they don't back away from it. Most practices out there would be happy if you just provided the insurance authorization service for them. But when they have one person handling everything from A to Z, and they are taking care of all of your referrals, that increases customer satisfaction tremendously."
The concierge system has given patient access staff an opportunity to work more closely with practices. "We are able to make them aware of procedures that require authorization," says Sutton. "Before, there was no ownership. They were calling into a central scheduling department. Even though the scheduler would tell the physician practice that they needed a medically justified code, there were so many calls coming in that sometimes the follow up was done and sometimes it wasn't done. Now, it's not going to get swept under the rug."
High frustration levels
Patients may have misdirected anger at patient access due to issues that actually have more to do with the provider's office. For instance, patients may become frustrated due to being put on hold when calling for an appointment, or not being able to get an appointment as quickly as they would like. Guess who they convey their displeasure to?
"Patients used to have a different perspective of physicians," says Patti Johnson, patient access clinic director at Affinity Health System in Menasha, WI. "Nowadays, patients feel their time is just as valuable as the physician's. And oftentimes, the patient takes their frustration out on the patient access staff."
Patients are annoyed when asked to repeat the same information each time they come for an appointment. "They think we should just know it already," says Johnson. "In most cases, we do have the correct information. But since it can change at any time, we need to make sure so we can file the claim correctly. We streamlined our registration process about 18 months ago by asking only the required questions to get a claim filed correctly."
Patients don't realize, however, that staff are required by the government to ask some of the information, such as Medicare Secondary Payer questions. "Some of our sites are doing pre-registration, calling the patient a day or two prior to the appointment to get the information," reports Johnson. "We are also in the process of implementing a patient portal. I think that will help with this issue. Patients will be able to update the information in the comfort of their home or office, at a time that is convenient to them."
For their part, patient access staff are challenged to identify and enter the correct insurance information in the practice management system. "Each provider has their own rules, dos, and don'ts. It is impossible to remember everything," says Johnson.
To shorten hold times during large call volumes, Affinity's access department has introduced phone menus, such as asking patients to "Press one to schedule an appointment."
"It's not ideal, and actually is probably more displeasing to some patients. However, it gets the call to the right departments and does save the patient time being put on hold," says Johnson. "Some departments have also added an informational message to play while the patients are in queue."
As for the problem of providers running late, about 15 minutes in the morning and afternoon is reserved to allow for some catch-up time. "This is a rough one to manage," says Johnson. "For patients that have a reputation for taking extra time, we attach a patient alert to the patient's account that instructs the scheduler, 'When scheduling this patient with Dr. So-and-So, always allow 30 minutes.' This has been very helpful."
[For more information, contact:
- Dee Sutton, Manager, Central Scheduling and Concierge Services, Bon Secours Hampton Roads Health System, 3636 High Street, Portsmouth, VA 23707. Phone: (757) 398-4228. Fax: (757) 398-2288. E-mail: [email protected]]
- Patti Johnson, Patient Access Clinic Director, Affinity Health System, 1570 Midway Place, Menasha, WI 54952. E-mail: [email protected].]
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content