There are certain complaints that likely are familiar to patient access staff. “The registrar was very friendly — until I asked how they came up with the amount I owed.” “The registrar’s tone of voice changed after I asked if she was really sure about my benefits.”
Shelita Russ, CHAM, director of patient access services at Louisiana-based Ochsner Medical Center - Kenner, Ochsner Health Center - River Parishes, and St. Charles Parish Hospital, recently fielded a few similar complaints. Each time, the patient stated that the registrar had spoken rudely during a collection conversation.
Russ set out to conduct a thorough investigation by speaking with each patient. She learned that most already knew they owed something, so the fact someone asked for money wasn’t the issue. Russ discovered a common thread to the complaints: The problem started when the patients questioned the amount the registrar quoted.
“I found that even some of the most experienced registrars sometimes resorted to a more assertive tone when being challenged by a patient while discussing liability amounts,” Russ reports.
Patients said the registrar’s body language and tone of voice changed.
“The registrar was no longer participating in an open and inviting conversation,” Russ says.
When Russ observed staff from the lobby, she saw that the patients were correct: “I observed this ‘change’ with multiple staff.” Russ spoke with her team and learned that they were very comfortable talking about the information that the insurance verifier had noted. Their discomfort stemmed from questions about the patient’s coverage that was not included in the benefits summary section.
“They became uneasy. It was clear that the patient had taken them out of their comfort zone and their overall demeanor changed,” Russ notes.
Better Responses Needed
It was apparent that more detailed training was needed to equip registrars to fully discuss patient liabilities.
“I also realized that there would be times in which the employee would not have the answer to the patient’s questions,” Russ says. Registrars needed to find a better way to respond in these instances.
Staff were asked to role play using scenarios that came up with different types of insurance issues.
“It was interesting to have the team create their very own scenarios,” Russ says.
Some examples included:
- A patient had a high-deductible plan and a large liability amount, but English was not the primary language.
“The staff had the challenge of communicating the patient liability amount through the language line,” Russ says.
- A patient had coverage that was terminated mid-month because of a job change, but the patient was adamant that he had coverage until the end of the month.
- A walk-in patient during lunch had a limited out-of-state policy that the staff had to call to verify.
“Additionally, this patient continued to use her cellphone during the registration conversation,” Russ notes.
Some suggested scripting:
- “I can certainly look into that for you.”
- “That is a really good question. Unfortunately, my notes do not include a full list of your benefits. However, I can contact the insurance company to get clarification if you would like.”
Russ says these tools made all the difference: “Scripting, additional training, and knowing that they could politely excuse themselves and pull in a senior coworker to assist.”
SOURCE
- Shelita Russ, CHAM, Director, Patient Access Services, Ochsner Medical Center - Kenner/Ochsner Health Center - River Parishes/St. Charles Parish Hospital, Louisiana. Phone: (504) 894-2912. Email: [email protected].
Registrars uncomfortable talking about benefits.
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