EXECUTIVE SUMMARY
With successful complaint management approaches, patient access leaders can turn unhappy patients into satisfied customers. Complaints decreased by 65% at The MetroHealth System by addressing front-end and back-end customer service issues with a Customer Service Advocacy Department.
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Patient access leaders use software to analyze patients’ and employees’ tone of voice.
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Registrars use scripting to calm upset patients.
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The department standardized expectations for verbal and body language.
Patients who had prothrombin time/international normalized ratio (PT/INR) labs drawn frequently at Thomas Jefferson University Hospital in Philadelphia often complained about having to wait when they came so often for the same lab services.
“These tests are of a ‘stat’ nature and must be processed immediately,” adds June Parks, patient access supervisor for outpatient registration.
In response to the patient complaints, patient access leaders changed the registration process. Registrars now immediately register the patients for their blood draws. “This fast-track process worked well for this population of patients, their physicians, and the registration department,” says Parks.
Access leaders at The MetroHealth System in Cleveland saw a 65% decrease in patient concerns as a result of a revamped approach. “In May 2015, the revenue cycle transformed our traditional Customer Service Department to our holistic Customer Service Advocacy Department, combining front-end access activity with back-end statement activity,” says Donna Graham, senior director of revenue cycle.
Of the few concerns that are received, only .01% require customer recovery. “We are connecting with our patients proactively,” says Graham. “We provide effective financial education to remove barriers to access and mitigate any concerns regarding billing.”
All patient access employees are encouraged to take the attitude, “I am the solution,” which is posted at their work stations as a constant reminder. “Each employee has this mantra on a mirror, as a reminder that they are accountable for providing the patient with a positive experience,” Graham says.
The department made these changes:
• A new department addresses both front-end and back-end complaints.
Previously, The MetroHealth System had two Revenue Cycle Call Centers. One handled front-end calls about financial counseling and Medicaid enrollment. The second call center was for back-end calls about billing statements.
“When assessing these calls, we identified that the gap of ‘front end versus back end’ needed to be closed,” Graham says.
With increased patient out-of-pocket costs due to high-deductible plans, Graham says, “the face of our self-pay population changed.” She adds that patients’ increased responsibilities for payment were a catalyst to address patients “holistically, rather than by insurance coverage versus self-pay.”
This one-stop approach meets patients’ specific needs, regardless of whether they have health insurance coverage or not. “In addition, we were able to maintain staff-neutral and meet operational goals for phone management,” Graham says.
These goals include expanded hours of operation for patients’ convenience and prompting patients to enter their phone numbers so the registrars can bring up the patients’ information. “An immediate personal connection is made with the patient,” says Graham.
Both call centers were combined into the Customer Service Advocacy Department. “All patient concerns regarding access, coverage, registration, and billing go to this department, if in writing or via phone call,” says Graham.
Calls are managed more efficiently, with fewer handoffs. “We have increased from approximately one million encounters in 2014 to 1.2 million in 2015, without adding staff to the revenue cycle department overall,” reports Graham.
• Trainers provide education with a focus on the patient’s point of view.
“Concerns are addressed timely and consistently,” Graham says. “Most are resolved same day or next day.”
The department uses speech analytics software. “We are able to assess the tone of voice of both patients and employees, and use ‘de-escalation verbiage’” says Graham. (See related story in this issue on how staff calm upset patients.)
• The department standardized verbal and body language used for “face-to-face etiquette.”
Staff are asked to sit straight, have an open and welcoming body posture, keep hands quietly folded, and uncross arms. They immediately introduce themselves by name and role, and they ask how they might be of assistance; during the discussion, they refer to the patient by name.
“This provides for a consistent and effective approach for managing our professionals and for patients to receive consistent advocacy,” Graham says.
SOURCES
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June Parks, Patient Access Supervisor, Outpatient Registration, Thomas Jefferson University Hospital, Philadelphia. Phone: (215) 503-0050. Fax: (215) 923-9458. Email: [email protected].
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Donna Graham, Senior Director, Revenue Cycle, The MetroHealth System, Cleveland. Phone: (216) 957-2519. Email: [email protected].
