Patient questions are getting tougher
April 1, 2012 4 minutes read
Patient questions are getting tougher
Training has 'huge impact' on bottom line
Will my insurance cover this visit?" is something patients often ask registrars in the emergency department at Sutter Delta Medical Center in Antioch, CA. However, the answer isn't as simple as it seems.
"This is a very common question, but we cannot provide a yes or no answer to patients," says registration manager Chris Hatcher. Instead, patient access staff are instructed to inform patients that all insurance vendors are billed, whether they are listed as a contract provider with the hospital or not, because payment is based on the patients' coverage and how their insurance policy determines emergent care services needed.
"Patient access clerks also receive questions related to charity care — how does one apply and how to qualify for the program," says Hatcher. These steps were taken to help staff provide accurate answers:
• Registration clerks use a script with responses to the most commonly asked questions.
"As staff brings to our attention new questions they receive from patients, we adjust our reference tool," says Hatcher.
• Staff members are instructed to contact the insurance provider with the patient present, if there are questions about coverage.
"Everyone can hear the same message. This helps eliminate any misunderstandings that could occur," says Hatcher.
Affects bottom line
Registrars at Skaggs Regional Medical Center in Branson, MO, attend quarterly training sessions to gain skills in answering difficult questions, says
Rebecka Sandy, CHAA, CHAM, outpatient financial counselor team lead.
"Access supervisors from registration, centralized scheduling, and financial counseling all provide the quarterly training," says Sandy. "The training sessions are given in one-hour sessions to include almost all shifts."
Recent topics have covered scripting for upfront collections, setting up payment plans, and preventing insurance denials. [The computerized graphic presentation used by Sandy for training in upfront collections and payment plans is included. Go to http://bit.ly/zvOgxQ. On the right side of the page, select "Access your newsletters." You will need your subscriber number from your mailing label. For assistance, contact customer service at [email protected] a or (800) 688-2421.]
Registrars learned the reason for recent claims denials, including a patient who had coverage with a Medicare HMO, and another patient whose name in the hospital system didn't match Medicaid's system. "All of these denials could have been prevented by properly reading the electronic eligibility," says Sandy, adding that additional training was provided to address this need.
If registrars are able to educate patients about insurance benefits and financial obligations, this helps them to know what to expect both during the present visit and future visits, says Sandy. "Without question, training access representatives to field a variety of questions has a huge impact on the hospital's bottom line," she adds. "If the patient is satisfied, they will not only use your facility, but will also recommend it to others," Sandy says. (See related story, below, on common questions from patients.)
Source
For more information on responding to patient questions, contact:
- Chris Hatcher, Registration Manager, Sutter Delta Medical Center, Antioch, CA. Phone: (925) 779-7249. Email: [email protected].
- Rebecka Sandy, CHAA, CHAM, Outpatient Financial Counselor Team Lead, Skaggs Regional Medical Center, Branson, MO. Phone: (417) 348-8930. Fax: (417) 348-8029. Email: [email protected].
Be ready to answer all these questions Here are some questions patients are asking registrars at Skaggs Regional Medical Center in Branson, MO, and what managers are doing to help staff to respond: 1. "Will my insurance cover this?" "Registrars need to understand the basics of how health insurance works, and the terminology used, in order to better educate the patient," says Rebecka Sandy, CHAA, CHAM, outpatient financial counselor team lead. Understanding insurance terminology is especially crucial when members of the front end staff are answering questions about benefits, she explains. "Typical concerns of patients are things such as what differentiates a copay from a coinsurance, or what constitutes an out-of-pocket maximum," says Sandy. 2. "Do I qualify for financial assistance?" "Providing a few key questions for front-end staff to interview the patient can help them easily identify if the patient may be eligible for the financial assistance program," says Sandy. Registrars ask these questions:
3. "What does my Medicare coverage include?" Patients often are confused about their Medicare coverage, especially those new to Medicare, says Sandy, and many don't know the difference between Part A and Part B coverage. Registrars might have trouble identifying when a patient has an additional payer, such as a Medicare Advantage plan or large group health plan coverage, says Sandy. She encourages her staff to use free web-based training available from the Centers for Medicare & Medicaid Services' Medicare Learning Network. (For more information, go to https://www.cms.gov/MLNProducts/03_WebBasedTraining.asp. Under the heading "Related Links Inside CMS," click on "Web-based Training (WBT) Courses."). "Many members of the staff have taken advantage of this. This is a great tool to prepare for the [certified healthcare access associate] exam," she adds. |
Will my insurance cover this visit?" is something patients often ask registrars in the emergency department at Sutter Delta Medical Center in Antioch, CA. However, the answer isn't as simple as it seems.
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