When patients hear about high out-of-pocket costs, did not realize their insurance would leave them with a large balance, or just did not know their copay was so high, registrars often bear the brunt of their frustration.

“This is the time to use active listening skills,” says Laurie Lawson, CHAA, a patient access lead at Kadlec Regional Medical Center in Richland, WA. This means staying calm, expressing understanding, and paying attention to voice tone and body language. Kadlec registrars follow a script to de-escalate tense registration encounters:

  • If patients say they can’t pay:

“I understand you owe a balance you are concerned about. Let me offer you a financial assistance application, and the phone number for billing. They can help set you up on a payment plan.”

  • If patient did not know a copay was owed:

“I understand you did not know you have a copay and cannot pay the full amount at this time. We can accept less than the full amount of the copay. How much can you pay? If you cannot pay anything, we can bill you. Would you like a financial assistance application?”

Lawson says how the registrar approaches the scenario, not the exact wording used, is most important. After the patient is visibly calmer, the next question is, “What else can I do for you? Can I get you a warm blanket or an extra pillow?”

Patients sometimes just need to vent. Taking the time to listen to their frustrations can help. “It usually takes away the anger, especially if the registrar offers empathy and a solution to the problem,” Lawson offers.

During new hire training at Children’s Mercy Kansas City (MO), patient access employees hear a lot about the importance of delivering exceptional customer service.

“We go much more in depth and discuss customer service recovery in our customer service retreat,” says Patient Access Manager Ashley Howard. This one-day class, held onsite and attended by all patient access staff within their first six months of employment, focuses on strategies for successful interactions. Employees learn steps to confirm understanding:

  • Use a confirming statement (“I want to make sure I understand your request.”);
  • Summarize key facts (“You want me to ...”);
  • Ask if your understanding is correct (“Am I understanding correctly?”);
  • Clarify the misunderstanding, if necessary.

“We ensure staff have the tools and resources to resolve the concerns and frustrations families may express,” Howard says.

Staff listen, empathize, apologize, and take responsibility. Is the patient still upset? It is time to contact a supervisor, manager, or patient advocate. It is not always possible for patient access to solve the problem, but they can point the patient in the right direction. If it a high balance the patient is worried about, simply connecting them with a financial counselor is the answer.

“Access reps are the frontline, and are often asked questions that often fall outside of their essential functions,” Howard says.

Patient access has the resources they need to move toward a resolution, regardless of the concern. “That may be to connect them with clinical staff, schedulers, billing, or security,” Howard notes.