Initially, many self-pay patients have a negative perception of financial counselors.

“By easing their financial burden, we gain their trust,” says Cris De Castro, CCS, manager of financial counseling for patient access services at University of California — Los Angeles Health System. “Patients see we are there to help them, not just to get them to pay such-and-such amount.”

Unity Point Health System — Rock Island (IL)’s Medicaid specialists and financial advocates recently took on the role of educating self-pay patients presenting at the health system’s 31 clinics and four Express Care Centers.

“That has been a big undertaking,” says Linaka Kain, manager of the Marketplace Exchange/disability examiner. “Previously, no one was counseling these patients. We started having them refer the patients directly to us.”

This change means that no self-pay patient falls through the cracks. “Sometimes at the hospital level, we forget about the clinic,” says Kain. “The patient will end up either in the clinic, the ED, or the hospital. It’s a circle, so why not close that gap?”

Financial advocates at Unity Point Health System — Rock Island tell newly insured patients how to use their coverage, how to establish a primary care provider, and how to use the emergency department (ED) appropriately.

“It’s not an easy process,” says Kain. However, the department already is seeing results: far fewer calls than the previous year. “Last year, we had so many people call us on the phone asking questions. We don’t have that this year,” says Kain. “The people we helped with enrollment are already educated.”

Medicaid specialists and financial advocates make a point of telling every newly enrolled patient awaiting insurance coverage, “Now we have assisted you in applying for insurance. It takes anywhere from 30 to 45 days to get a decision. But if you find yourself feeling poorly and in need of medical attention, go to the closest ED and seek care. Don’t think that you have to wait until you get your insurance decision. Your welfare and safety comes first!”

“We don’t want something catastrophic to happen because they think nobody will take care of them,” says Kain.

In cases in which a patient is in a pending status for Medicaid and ends up not qualifying, but has an unexpected ED visit during that time, the hospital then would apply for charity assistance.

“We had one instance where the patient was having a heart attack and went to the ED,” says Kain. “Having somebody tell them, ‘If you need it, go to the ED,’ could have saved their life.”