Financial counselors and self-pay team members always worked jobs that overlapped somewhat at Bronson Methodist Hospital and Bronson LakeView Hospital in Michigan. Still, the two groups of employees rarely, if ever, met in person. That changed after four hours spent working alongside one another.

For financial counselors, “it was an eye-opening experience. They saw that self-pay staff are just as busy as they are,” says Darlene Powell, patient access manager at Bronson Methodist.

The two roles are different in some important ways. The self-pay team works strictly offsite, interacting with patients only over the phone. Typically, conversations are about past due bills. In contrast, financial counselors meet with patients at the bedside. “We don’t get into deep details of the patient’s bills,” Powell says. Instead, financial counselors help patients apply for Medicaid, and work with Department of Health and Human Services workers as advocates for the patient.

Financial counselors were very surprised at how high the call volumes were, fielded by the self-pay team, and how quickly they worked.

“The self-pay staff are usually trying to keep calls at a short time frame so the queues don’t back up,” Powell explains. Financial counselors are used to a difference pace with their face-to-face encounters. Other people waiting can see there is someone else receiving help. “They know there will be a wait,” Powell says. “The financial counselor can spend additional time with a patient when necessary.”

What was most amazing to financial counselors was the speed at which their colleagues switched back and forth between multiple screens. Financial counselors learned some shortcuts. “Epic has several different ways you can see the same information, and some ways are shorter than others,” Powell explains.

Initially, the plan was for the self-pay team to shadow financial counselors, too. “Due to staffing issues in self-pay, we have had to delay that for a while,” Powell reports.

Self-pay staff are eager to improve their communication skills. They believe they can learn a lot by observing in-person encounters. “It’s much harder to tell a patient you aren’t able to assist them financially over the phone than in person,” Powell notes.

At one point, multiple phone calls took place between the teams. “These calls centered around patients with complex financial needs,” Powell recalls. The two groups figured out how to avoid all the back-and-forth. The problem was that billers were hearing questions that were beyond their expertise. Patients wanted an explanation of why a decision was made to deny them financial assistance. Some asked that a decision to deny charity care be reversed.

“We created some great reference guides on the top questions that self-pay deals with daily and correct responses to them,” Powell says, noting that this included definitions of terminology, codes, and billing indicators. “This was a big win for the staff. They really appreciated it.”