What’s even more critical for access? Service
It’s how you ask for payment
There is a growing emphasis on “sensitivity in hospital collections” that patient access staff should be aware of, advises Richard L. Gundling, FHFMA, CMA, vice president of healthcare financial practices for the Healthcare Financial Management Association (HFMA).
“We are going to be dealing with this issue for a long time,” he says. “Patient access are the people the patient sees first. They are often the ones who ask for the first copay or deductible.”
Patient access staff must communicate financial expectations in “a professional, kind way,” says Gundling. “We often hear about ‘shared accountability,’ but what that really means is the patient pays more,” he says. “The brunt of that is also on the revenue cycle staff, because they are the ones collecting that from the patient.”
Collecting upfront doesn’t have to mean dissatisfied patients, even if a large out-of-pocket responsibility is due, emphasizes Gundling. In focus groups conducted by the HFMA’s Patient-Friendly Billing project, patients preferred knowing payment obligations before they have the service. “This offers the opportunity to comparison shop for services and learn about payment alternatives including financial assistance,” Gundling says. “We find patients are much more angry on the back end, when they are surprised by the bill.”
Telling patients their out-of-pocket responsibility gives them time to discuss it with their physician if necessary. “They can have a discussion about their care and explore other alternatives. They may find out that can do something differently and avoid a high deductible,” Gundling says.
Patient access managers should make the ability to show compassion and respect a top priority with new hires, he advises. (See related story on assessing customer service skills of applicants, p. 102.) “I have seen many examples of hospitals with high revenue cycle metrics and high patient satisfaction scores,” says Gundling. “We know it can be done.” He recommends:
• Give customer service training to all patient access staff.
“The healthcare environment is filled with medical and billing jargon and acronyms,” he says. “Tell staff to put themselves in the patient’s shoes.”
Pay close attention to messaging and communication practices around collections, such as having staff use carefully crafted scripts, providing clearly worded billing and collection materials, and making resources available in the most prevalent languages, Gundling recommends.
• Make prices more transparent.
“Technology is aiding these efforts,” says Gundling. “Some hospitals are able to apply a payer’s negotiated contract rate, deductible, copayment, and co-insurance percentage to get an accurate estimate of the patient’s out-of-pocket payment.”
• Ask access staff for ideas.
“Involve them in improvement processes,” says Gundling. “They are talking to the patients directly. They know what works and what doesn’t.”
Some hospitals provide journals to their staff members so they can write their interactions with patients, peers, and other departments, and these are then shared regularly to engage in better customer service, he adds.
• Consider the unique needs of your community.
Gundling did a site visit at one hospital that served primarily low-income patients and yet had very good revenue cycle metrics because they had excellent processes for helping patients qualify for Medicaid.
“It’s not always going to be one size fits all,” he says. “If you are an inner city hospital, patients’ needs are going to be very different than in the suburbs.” (See related story on obtaining feedback on access processes from the community, below.)
Resource
• A report on strategies to promote patient-friendly financial communications from the HFMA’S Patient Friendly Billing project can be accessed at no charge at www.hfma.org. Click on “HFMA Initiatives,” “Patient Friendly Billing,” “Case Studies in Customer Service,” and “View.”
There is a growing emphasis on sensitivity in hospital collections that patient access staff should be aware of, advises Richard L. Gundling, FHFMA, CMA, vice president of healthcare financial practices for the Healthcare Financial Management Association (HFMA).You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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