Having better financial conversations with patients “is clearly a big priority for us,” reports Laura Semlies, MPH vice president of finance and revenue cycle transformation at Manhasset, NY-based North Shore LIJ. “We’ve modified many of our processes and spent an awful lot of time on education,” Semlies says.
Patient access staff members do these things to improve financial conversations:
• Suggest some questions for patients to ask their insurance carriers, such as “How much would my premium be if I had a lower coinsurance?”
These questions help some patients lower their out-of-pocket costs going forward, says Pattie Froehling, vice president of revenue cycle management for Eden Prairie, MN-based Optum 360 and former director of the revenue cycle at North Shore-LIJ.
• Give patients every possible option.
“We give them all of the avenues to go down,” says Froehling. These avenues might include setting up an interest-free payment plan, applying for Medicaid, or applying for charity care.
• Make sure patients are speaking to someone who is fully informed.
“You cannot walk into a patient’s room unless you know your facts,” says Froehling. “If you are not sure of the insurance details, don’t have the conversation until you are sure.”
This statement is true whether the patient received a paper statement and contacted the call center with a question, is speaking on the phone to a financial counselor to pre-register, or is meeting with someone at the bedside prior to discharge from the hospital.
Froehling says that regardless of how or where the financial conversation happens, “the person speaking to the patient has to be extremely knowledgeable. That person is not saying, ‘I’ll get back to you, and frustrating the patient.”
Not everyone is cut out for this challenging role. “It’s a special type of person who can speak to the patient about money,” says Froehling.
The department rolled out point-of-service collection training in which staff members are videotaped so they can see their body language. “From there, we try to work with that person,” says Froehling. At times, registrars immediately say, “I just can’t do this.”
“We have moved people out of roles who found it too challenging to have a productive financial conversation with the patient,” says Froehling.
Patient access staff members are given some general scripting, but they are encouraged to be conversational. “If I’m robotic, then I’m no different than a telemarketer,” says Froehling. “We are far more than collectors. We are financial coordinators, counselors, and advocates.” (Editor’s Note: The November issue of Hospital Access Management reported on financial counseling processes used by patient access.)
