Depending on the registrar’s delivery, telling patients how much money they owe for services delivered and asking how patients would like to pay can come across as easygoing or robotic.
“I have found that requiring team members to follow scripting verbatim makes them sound robotic. Patients can sense this,” says Will Brown III, MBA-HCM, manager of patient access services at Baptist Medical Center South in Jacksonville, FL.
He says two things happen in this situation: Patients are less likely to pay what they owe, and they’ll think poorly of the organization for trying to collect from them in their time of need.
“Scripting should be tailored so team members can speak confidently with patients on their financial responsibility for services rendered and still create an opportunity for their personality to show,” Brown says.
Listen More Than Talk
When coaching on collections, Brown tells employees to “be patient, be confident, and listen more than you talk.”
Sometimes registrars are so nervous that they don’t wait for the patient’s response.
“I’ve seen team members talk themselves out of a copay by assuming the amount is too high for a patient,” Brown says.
First, the registrar tells the patient the amount that is due. Next, he or she states that the patient can take care of the payment via cash, check, or credit card.
“This is where we use what I call the ‘awkward silent’ approach,” Brown explains.
The discussion pauses until the patients respond with how they will pay or if they cannot pay. This technique is especially helpful if registrars are hesitant to ask for money.
“They do not get engaged in the uncomfortable back and forth that occurs with some patients,” Brown notes.
Most patients are receptive to this approach. Successful collections boost the registrar’s confidence for future conversations.
“It also helps with team members that may collect too aggressively, as it limits their opportunity to say things to patients that may be questionable,” says Brown, who recommends these two approaches:
- Find a script that works for your patient population. “Then stick with it, and hardwire it through consistent training and role playing.”
- Shadow team members from time to time. “Help them tweak their approach after a failed collection attempt.”
Train Thoroughly
Tara Farrington, registration supervisor at Genesis Medical Center-Davenport (IA) and Genesis Medical Center-DeWitt (IA), has seen a $30,000 increase in ED collections from fiscal year 2015 to fiscal year 2016. She credits the success to the following:
- Engaging in face-to-face financial discussions instead of over the phone.
“We want to have these conversations with the patients while they are in front of us,” Farrington says.
This system allows patients to ask questions and share concerns in person with the registration team, instead of trying to understand their statements at home by themselves.
- Ensuring registrars fully understand terms such as deductible, coinsurance, copay, and out of pocket.
“This can help our team better explain the breakdown of benefits to the patient,” says Farrington.
- Tweaking the scripting so it encourages patients to pay their bills.
Registrars use scripting such as, “How would you like to pay for that today?” or “How will you be paying today?” instead of, “Are you able to pay today?” Or “Would you be able to pay for that today?”
- Will Brown III, MBA-HCM, Manager, Patient Access Services, Baptist Medical Center South, Jacksonville, FL. Phone: (904) 271-6134. Fax: (904) 391-5913. Email: [email protected].
- Tara Farrington, Registration Supervisor, Genesis Medical Center-Davenport (IA)/Genesis Medical Center-DeWitt (IA). Phone: (563) 421-2211. Email: [email protected].
At Ann & Robert H. Lurie Children’s Hospital of Chicago, some registrars feared confrontation or being put on the spot if they asked for money. Others correctly stated what the patient owed, but their statements appeared to be scripted.
“Representatives must engage the consumer in conversation, versus simply stating, ‘This what I see, and this is what you owe,’” says Robin Speaks, MSHSA, CHAM, director of admitting.
To address this, the department pairs one or two reluctant collectors with an experienced collector to “show them the ropes.”
Here are some tips that the high-performers shared:
- Practice the art of conversation.
“Rattling off a bunch of scripted words that do not fit the scenario is time wasted, non-valued, and a dissatisfier to the consumer,” says Zander Davis-Washington, director of ambulatory support at Lurie Children’s outpatient clinics.
Instead, registrars carefully listen to what the patients are saying, so they can engage in a true conversation.
“The registrar may refer the patient to appropriate resources such as financial counselors, social workers, or patient relations,” Davis-Washington adds.
- Always make eye contact with the patient.
Eye contact allows the registrar to “read” the patient’s facial expression. “If there is high anxiety or worry from the consumer, deflect the conversation for a moment, but come right back to it,” Davis-Washington advises.
“Do not give consumers a choice not to pay before you have heard their response, just to keep the line moving,” Davis-Washington says.
- Say different things, depending on the division.
Depending on the area the registrar works, he or she must be able to engage in financial discussions on facility, physician, surgical, and anesthesiology fees.
“All of the right tools and resources must be in place so representatives can have an informed and intelligent conversation with the consumer,” Speaks says.
Since “one-size fits all” scripting doesn’t work, patient access leaders came up with a list of situations and effective responses.
“What applies to one division does not necessarily apply to another,” Speaks explains.
- Zander Davis-Washington, Director, Ambulatory Support, Ann & Robert H. Lurie Children’s Hospital of Chicago. Phone: (312) 227-3145. Fax: (312) 227-9801. Email: [email protected].
- Robin Speaks, MSHSA, CHAM, Director, Admitting, Ann & Robert H. Lurie Children’s Hospital of Chicago. Phone: (312) 227-1231. Fax: (312) 227-9710. Email: [email protected].
