To really be transparent on hospital prices, good conversations are needed with highly trained, service-oriented staff. “Patients often feel overwhelmed. They don’t fully understand the message that is being communicated,” says Kaylin Fogarty, director of patient access at Tufts Medical Center in Boston.
Usually, when things go poorly, Fogarty says it is because registrars fail to properly introduce themselves, do not provide the patient with a clear purpose of the call at the beginning of the conversation, or start the discussion at the wrong time.
“We try to avoid having any financial discussions with patients close to their admission date,” Fogarty explains. The night before an inpatient admission or surgical procedure is not the right time to talk about money.
“Often, patients are not aware of their cost-sharing,” Fogarty says. Some are surprised (and skeptical) that they owe anything at all. “If this is the first time they are hearing this, they often question if the information is accurate,” Fogarty notes.
Sometimes, patients receive false reassurance after they hear that a procedure is “authorized” by insurance. That does not mean it is going to be 100% covered. “It takes some additional explanation of how insurance plans are set up and how benefits can vary from plan to plan,” Fogarty says.
Regardless of how upset or frantic the patient sounds at first, registrars try their best to stay calm and helpful. “Patient access team members really put themselves in the patient’s shoes,” Fogarty says. Staff members do not rush the conversation; they take time to listen to the patient. Then, they explain how the price was calculated. Sometimes, additional research is needed.
“It’s important to explain any additional resources that may be available to the patient, including payment plans and secondary insurance,” Fogarty says.
Staff bear in mind nobody wants an unexpected expense and do what they can to help. “Even though it may seem as though we have the hospital’s finances in mind, we also have the patient’s well-being in mind,” Fogarty adds.