Issue link: https://beckershealthcare.uberflip.com/i/501108
40 Revenue Cycle Q: Speaking of registration, it seems the ability to furnish accurate estimates up- front is becoming a necessity. How does this capability help with point-of-service and pre-service collections? And how do you go about securing them? CD: With the rise of high-deductible plans, we realized that we needed to spend time with that patient who is going to have a fairly large bill. Patients have choices, especially with scheduled outpatient work, and they want to know what they'll owe after insurance. Without an estimator tool, you can't estimate anything other than gross charges, and that's not really helpful. We use our estimator tool to determine pa- tients' eligibility, deductible and co-insurance. Later, we go to the bedside and let them know that we validated their insurance, so they don't need to worry. If they have an unmet deduct- ible, we'll ask if they would like to set up a pay- ment plan. After the discussion, the patient can choose from multiple options on a "payment options form" — online, check, credit card and payment plans — and we record it in the docu- ment imaging system. Q: At the other end of the care cycle, what's the role of statements today? Are you simplifying them, making them easier to understand? CD: Absolutely. I look at the billing process as the pre-registration for the patient's next visit to my hospital. When someone's had a good clini- cal visit and is happy, and then our statement is hard to understand or there's a billing problem, then they're no longer happy. Statements must be really simple and say, 'Thank you for using us. We billed your insurance. This is your portion. Let us know if this is not right.' If they owe $500, it should be clear that they owe $500, without a bunch of other noise. Simplification is what we do first. Every statement refers patients to our website, where they can pay online and get answers to fre- quently asked questions. And everything we send lets them know financial assistance is available. Q: What about your financial counselor? How do they work with patients? CD: We refer to financial counselors who visit patients at the bedside as financial advocates. They're advocating for the insured patients. So the same person you see at the bedside discussing insurance will call and say, 'Hey, your insurance is paid now.' Or, 'Claims came in and a refund will be mailed this week.' We're trying to establish a personal business re- lationship with patients. I want patients to know that person is their financial advocate and is going to work with them through any issues, and they can contact that person instead of calling custom- er service and waiting in the queue. Q: Has this helped reduce your call volume? CD: Oh yes. Online bill pay through RelayAccount and the use of financial advocates has reduced our call volume and resulted in a 10 percent drop in call abandonment. More patients are going online to see what their bill is and paying right there — we now collect 40 percent of patient payments online and have collected $40 million online to date. Q: If you were to offer other best practic- es for supporting patient payment clarity, what would they be? CD: All employees with patient contact must be knowledgeable about insurance, payments and processes. And you need a good marketing plan for your online bill pay portal, your statements and your use of technology. Be sure employees understand your estimation tool. It's crucial to understand how to estimate payments and the conversational scripting that goes with it. Be certain that what you tell patients is the same thing they'll get in writing, and that your employ- ees are saying all the things that you need them to say. You want everything to be clear, simple and personalized. Don't assume that the patient knows what you're talking about. Listen to your employees. They are on the front line with patients. Get their feedback on things that are confusing or concerning patients. They know where they need better answers, more edu- cation or more support. Make sure they're trained to help a patient in any way possible, instead of saying, "You need to call the billing office." n