Don't give patients wrong benefits info

It's a 'patient dissatisfier'

If you tell patients they owe their entire deductible of $2,000 for an inpatient procedure, and they know that $1,700 of the deductible already was met, your credibility and competence are suddenly in question.

"The patient may be reluctant to pay and possibly not be pleased with their services," says Linda Cousin, manager of admission/registration at University of Mississippi Health Care in Jackson. The hospital's patient access specialists take these steps to be accurate:

They refer to notes in the registration system on specific benefits the patient is eligible for and outstanding healthcare balances.

• They use a web-based application that lists a patient's remaining deductible, co-pay, or co-insurance.

• They contact the payer to verify account balances on file, if the patient was not pre-registered or pre-admitted prior to check-in.  

"Afterward, staff give full disclosure and education to the patient on any information that was received, with a display of openness for any questions," says Cousin.

If incorrect information is inadvertently given, says Cousin, the registrar apologizes and acknowledges the mistake. "The patient access specialist could also inform the supervisor of this patient encounter," she says. "He or she can also assist in developing procedures to address the patient's direct concerns." To avoid this, these steps are taken:

The manager meets with the employee to ask pertinent questions related to the matter.

• If necessary, the manager provides clearer instructions or training.

• The manager follows up with the employee to assess how well the process is going.

• Management offers assistance as needed, to ensure that the processes are working.

Escalate as needed

When you make an incorrect estimate, it always has the potential to be a patient dissatisfier, says Debbie Milke-Wurster, RHIT, revenue cycle manager at Central DuPage Hospital in Winfield, IL. Their training program includes service recovery.

"These types of cases can be escalated to a management level," Milke-Wurster says. Registrars need the right tools to provide a clear financial picture, she emphasizes. "The word 'estimate' is a challenge in itself," Milke-Wurster says. "Patients prefer to know the specific amount as opposed to an estimate."

At Central DuPage, a registration educator helps staff to consistently provide accurate financial information to patients. "Information is constantly changing. Hospitals need the right processes to stay on top of the most current information," says Milke-Wurster. "We are working more closely with departments which provide charge information, to stay abreast of this."

Processes that start the financial discussion pre-encounter are the most effective, she says. "The more time we can give our patients to review the information to make an informed decision, the better," Milke-Wurster says.

Sources

For more information on giving accurate information to patients, contact:

• Debbie Milke-Wurster, RHIT, Revenue Cycle Manager, Central DuPage Hospital, Winfield, IL. Phone: (630) 933-3038. Fax: (630) 933-2628. E-mail debbie_milke-wurster@cdh.org.