Gauge patient reactions to POS co-pay process

When a new emergency department (ED) bedside co-pay collection process was implemented at Middlesex Hospital in Middletown, CT, access reps were "very, very nervous about what the reaction was going to be," recalls Margaret Trudel, patient access manager.

Access representatives were pleasantly surprised when many patients told them they liked the new process and found it easier, she says.

After the co-pay was solicited, the access representative then asked the ED patient how they felt about the new process. "It was presented in a positive light," says Trudel. "We were kind of selling it to them by involving them in the process."

Staff told ED patients, "We are piloting a new program, and we are interested in your feedback. Statistics show patients find this to be more convenient, because it saves them an additional stop on the way out and affords them more privacy when paying their co-pay." Patients then were asked to rate the process. "The majority of responses were positive," says Trudel. "Out of 298 patients surveyed, only one response was negative."

Still, Trudel is keeping a close eye on Press-Ganey patient satisfaction survey results, in the event some of the ED patients were not being forthright. "Usually, if patients are unhappy, they will comment on the bottom of the survey," she says. "The assumption is that if we are going to hear that patients were offended by being asked for money at the bedside, we will hear about that on the surveys."

The encouraging survey data on satisfaction was a factor in the decision to roll out the bedside co-pay collection to the rest of the main ED, says Trudel.

Avoid mixed messages

When access representatives at Middlesex ask patients for their co-pay on the day of a scheduled procedure, they aren't sure how to respond if the patient replies, "The nurse told me not to bring anything and leave my valuables at home."

To avoid this kind of confusion, access reps make every effort to collect the copay before the patient arrives. "We really want to get the payment while on the phone during the verification process prior to them arriving," says Trudel.

She is working with the nurse manager in surgical services to be clear about what patients need to bring with them on the day of the procedure. "Their goal is different than ours," says Trudel, adding that the nurse is usually the last hospital employee to speak to the patient prior to the date of their procedure. "While we don't expect them to discuss money matters with the patient, we do want them to remind the patient to bring their license, insurance cards, and co-pay if applicable," she says.

Some nurses are more willing to do this than others, says Trudel. "We have already had the conversation with the patient," she says. "The nurse is not really discussing finances. He or she is just reinforcing the message."