Before patient access leaders at Peoria, IL-based OSF Healthcare implemented a new point-of-service collection initiative, patients were asked for their opinion.
“We went to our Patient Advisory Board to further understand what patients wanted,” says patient access service manager Jacqueline Doerman.
Patient access leaders expected that the patients would be resistant to efforts to collect money upfront, but they received an unexpected response. “They wanted to be informed consumers. They didn’t want to get surprised by a huge bill and all the frustration that comes along with it,” says Doerman.
Most patients indicated that they wanted to know at the point of scheduling what they would owe. “Once that was confirmed for us, we set about coming up with additional options for patients, such as payment plans or other avenues,” says Doerman.
Still, the change wasn’t easy for patients or employees — or patient access managers. “It was challenging to manage the culture change the patients were facing, as well as the changes our employees were facing,” says Doerman.
Many staff members simply were uncomfortable asking patients for money. “Most of it was just getting used to asking for it and finding their comfort zone. It’s not an easy topic to discuss,” Doerman says.
Patient access managers held training sessions for employees to give them the scripting and background of the project. Instead of just giving an amount to the patient, staff members are able to provide details about what the service was, the amount covered by insurance, and the patient’s responsibility. “Some staff needed help reading the account correctly, and explaining why the patients owed the money,” says Doerman.
Some employees worried that it would take too much time to set up payment plans during registration, which could cause the patients to be late to their scheduled appointments. Revenue cycle trainer Mickey Stewart says, “Some staff expressed to me that they just are not comfortable enough with the computer and the different programs to obtain the information to set up the payment plans for the patient.”
During refresher training, Stewart reviews all components of cash collecting, including posting a copay, posting an estimate, posting a previous balance, and setting up a payment plan.
“This helps them understand where they need to go to look for the information to provide the patient with a payment plan,” says Stewart.
PATIENT ACCESS CAN ASSIST
In 2015, patient access leaders at Chesapeake Regional Healthcare in North Chesapeake, VA, updated the hospital’s financial aid policy.
“The policy was revised to be more consistent and understood by the registration and billing teams,” says Melissa Viohl, CRCR, director of patient access.
Patient access employees were trained in these three areas:
• Employees were trained to follow the new process for all patients, regardless of insurance status.
“This includes providing copies of the financial aid applications to any patient expressing concern,” says Viohl.
• They were trained to understand the federal poverty guidelines.
• They were trained to use scripting for financial discussions.
When a patient is pre-registered, registered, or being provided with financial counseling, the goal is the same: financial clearance of the account. “This means there is a financial pathway determined for the patient, either through payment plans, charity, or review for Medicaid or Health Insurance Exchange eligibility,” says Viohl.
Even after the new financial aid policy was implemented, there was still an unmet need for financial counseling in decentralized registration areas. “A project was initiated that moved financial aid processing from the back end to the front end, for all areas of the organization,” says Viohl.
Three financial counselors were added to the front end. “It was projected that the addition of these counselors will result in an after-salary ROI of approximately $200,000, in proper classification of bad debt versus charity for indigent populations,” says Viohl.
The department also expects to see reduction in authorization denials and increased point-of-service collections for self-pay populations. “This project was implemented in the first quarter of 2016, with a high expectation for patient satisfaction,” reports Viohl.
In 2016, Chesapeake Regional Healthcare will work toward becoming a certified application counselor organization, to assist patients in obtaining coverage through the Health Insurance Marketplace. “Many of our access staff will be certified to be application counselors,” says Viohl.
Mickey Stewart, Patient Access and Accounts Center, OSF Healthcare, Peoria, IL. Email: [email protected].
Melissa Viohl, CRCR, Director, Patient Access, Chesapeake Regional Healthcare, North Chesapeake, VA. Email: [email protected].