Win the loyalty of physician offices

Make their patients much happier

Often, physician offices aren't aware of the differences between hospital insurance requirements and provider requirements, which creates tension between the two areas, says Kellie Hawkins, director of patient access for Shady Grove Adventist Hospital in Rockville, MD.

Physicians might be confused about the requirements of health maintenance organizations, medical assistance plans, and managed care organizations, for example, because these can differ from requirements of outpatient surgical centers.

"Participating physicians frequently don't need an authorization or pre-certification to perform procedures at an outpatient surgical center," Hawkins explains. "However, if the physician is scheduling the procedure at a hospital versus a surgical center, the facility may need an authorization number to ensure payment."

Patients more satisfied

"The relationship between providers and the patient access department can be challenging," acknowledges Hawkins. "But various forms of communication, at key moments, can lead to a great experience."

The key to a provider's heart is often through the customer, says Hawkins. "Many times, the registration process is seen as a necessary evil," she says. "Providing an excellent experience for the patient is a sure way to earn a provider's loyalty."

Hawkins recommends taking these steps to improve relationships between patient access and providers:

• Work directly with the patient.

"As the patient access representatives work with specific customers, providers often find themselves in the middle of the conversation," says Hawkins.

Patient access can remove some of that workload for providers by working directly with the patient to do scheduling, verifying insurance, and setting up payment options, she suggests. "This can be a huge time-saver for the provider. It reduces the back and forth needed when a third party is involved," she says.

• Complete everything that is necessary for the patient's visit prior to the date of service.

This step might include phone or online pre-registration, verification of benefits, insurance authorization, administrative consent, and patient financial responsibility, says Hawkins. It allows the patient access team to "fast-track" patients, she says.

"The patient can bypass the facility's registration area entirely and go directly to their destination for care," she says. "Both patients and physicians ask about this feature when planning for an upcoming appointment at the hospital."


For more information about improving satisfaction of physician offices, contact:

• Kellie Hawkins, Director, Patient Access Department, Shady Grove Adventist Hospital, Rockville, MD. Phone: (240) 826-6299. Fax: (240) 826-5383. Email: