Turn a frustrated patient into a satisfied customer

It's OK to get personal

More than ever, patient access staff are coping with angry and frustrated patients. This may be because they lack insurance, are worried about their coverage, or just don't have the money to pay. "We do see many more patients that have financial problems today than a couple of years ago," says John E. Kivimaki, director of patient accounts at Mary Rutan Hospital in Bellefontaine, OH. "Our charity write-offs have increased from $880,000 in 2008 to $1.5 million through November 2009. This is almost a 60% increase."

For this reason, all self-pay patients and those with limited health care coverage are handed information on charity and financial assistance programs. A brochure is included that states, "We are here to help," and "Your ability to pay for services should not prevent you from receiving the medically necessary care you need."

"We have seen tremendous increases in our charity applications and approved accounts over the last couple of years," reports Kivimaki. "This is because there are more patients that have no or limited health care coverage. Our registration staff are making our patients aware of what we can do to help them. Many of our repeat patients that qualified for charity previously know they can qualify again for their current services. This eases their mind and makes them a much better satisfied patient."

These words calm patients

Andrea Chang, director of patient access for Conifer Health Solutions in Frisco, TX, says patients are frustrated because their household income has decreased, because they or their spouse have lost a job, or their insurance plan has changed and requires higher deductible, co-pay, or out-of-pocket expenses. "Many people do not understand the changes and how it impacts them," says Chang. "Or, other expenses may have increased, and they do not have the funds available to pay for an unexpected illness or procedure."

In this case, several things can be done to calm the patient. "We assure them we understand their position and we are here to help," says Chang. "Understand that the patient is already sick, hurting, or scared, and that is the reason for the emotion. This will give the registrar the right frame of mind when dealing with difficult situations."

Chang gives these examples of scripting, which can "hardwire the phrases that can turn the situation around":

• Use phrases that show empathy, such as "I'd be angry, too, if I did not know that my out-of-pocket expense of $5,000 had to be met before my insurance company would pick up 100% of the bill."

• Use phrases that show you will take responsibility to assist them, such as "There is something we can do to ease your frustration today. We have several payment options to choose from."

It also doesn't hurt to get a little personal at times. "Using some self-disclosure often helps the patient realize that the registrar accepts them as a person," says Chang. For example, staff might say, "I understand how you feel. I work here and we have a co-pay, as well as being responsible for 20% of our bill as well," or "I can sympathize with your situation because I recently had an unexpected illness. I had to use the same payment options I am offering you."

"Letting them know you understand their viewpoint makes them feel more comfortable and that you care," says Chang. "Stay calm and show respect. And show you are listening by allowing the person to speak without interruptions."

[For more information, contact:

Andrea Chang, Director, Patient Access, Conifer Health Solutions, 12505 Lebannon Road, Frisco, TX 75034. Phone: (972) 963-3067. E-mail: andrea.chang@tenethealth.com.]