By Lindy Benton, Vyne Medical
Patient communication, particularly on the front end of the patient’s visit, is critical to reducing bad debt and increasing point-of-service collections. Recent studies show that patients experienced an 11 percent increase in average out-of-pocket costs in 2017, with more than 50 percent seeing a per-visit out-of-pocket cost greater than $500.
This requires a new mindset for the revenue cycle, which in most cases bookends the patient’s overall care experience. Providers need to take a more upfront, consultative approach when talking with patients who are facing high bills and who often lack a full understanding of their benefits. As one healthcare provider put it, “We triage on the medical side; we should take the same approach on the financial side. It’s about caring for the whole person.”
A recent article recapping the revenue cycle themes from the HIMSS18 conference stated, “The policies and procedures surrounding this front-to-back operation should be built on personalization of patient interactions, knowledge of consumer preferences, flexibility and clear communication where the patient understands what they will be responsible for and will have options to fulfill their obligation that suit their particular situation. It's the experience they have come to expect, and it's something that may be present in other areas of care delivery but that has been lost a little in the realm of revenue cycle.”
And that may be because these conversations do not come naturally to all employees. Staff need training in best practices for patient financial communications – how to consult with patients about their benefits and to have clear, focused conversations about financial matters.
Industry organizations, such as the Healthcare Financial Management Association (HFMA) and the National Association of Healthcare Access Management (NAHAM), have provided resources to assist providers in navigating these delicate conversations. HFMA designed its program for best practices in patient financial communications, for example, to bring “consistency, clarity and transparency” to financial discussions with recommended steps for each setting, as well as a framework to measure compliance. Similarly, NAHAM’s AccessKeys provide KPIs to measure front-end performance in areas, such as collections, patient experience, quality and productivity.
Providers are also looking to technology to assist efforts in patient financial communications. Patients increasingly want the ability to connect in a variety of ways by texting, emailing or scheduling a call back instead of waiting on hold. When a connection does occur, providers need to make it count. The patient expects accurate, concise information – which means employees must have real-time access to that data.
To give patients a complete picture of their healthcare experience, providers need tools to structure data so it can be easily searched and retrieved. Software is now available to capture and integrate voice, fax and electronic exchanges that occur across the revenue cycle. Records can be digitized and tied to the patient account for search, retrieval and sharing.
Hospitals are using such technology to record phone calls with payers, physicians and patients. Revenue cycle associates record calls through a USB connection to their PCs and index recordings to criteria such as patient, physician, insurer and date of service. Hospitals also use the technology platform to capture and digitize faxes from physicians and payers, as well electronic exchanges from payer web sites and ancillary systems.
By integrating with the EHR, staff can automatically index recordings to the patient record while talking with a patient without changing screens. Building in these efficiencies minimizes clicks and allows staff to capture important data while still engaging effectively with the patient.
Once indexed, recordings and documents are searchable and retrievable for playback and viewing through a web-based portal. Links to the records can also be automatically exported to the EHR and placed alongside the care record to form a more a complete view of available patient data.
Associates use the technology to capture each step of the patient encounter, beginning with the faxed or electronic order from the physician. They record scheduling and pre-registration phone calls with patients, capturing important details, such as demographics, procedure instructions and out-of-pocket estimates. Recordings are later referenced for quality assurance, data accuracy and issue resolution. Associates also document phone, fax and electronic communication with payers and reference records to prevent and overturn denials by providing proof of patient authorization.
On the day of service, registrars record in-person conversations with patients using small desktop microphones attached to their PCs. By comparing patient encounters prior to service with those that occur on the day of service, leaders can reduce unnecessary duplication and ensure the accuracy and consistency of information provided at each touch point.
To conduct quality assurance of revenue cycle encounters, leaders use online scorecards to track performance by agent, team and key measure. Audio search allows managers to search selected recordings for key words and phrases to ensure they are used consistently or to eliminate those that should not be used.
Screen recording complements the QA process by adding video to existing audio recordings. Managers can recreate an entire event by not only hearing the recording, but also seeing video of what was happening on an agent’s screen. By utilizing this type of technology, organizations can further drive compliance and quality objectives for their staff.
Through this process, providers can capture and integrate patient financial data, such as benefits, financial clearance and pre-registration information, for enterprise access and exchange. Hospitals leverage data to assist patients in making informed care decisions, ensuring coverage for services and communicating upfront the cost of services and the role the patient’s insurance will play.
The process of recording revenue cycle conversations – both phone and in-person – gives providers a more comprehensive view of the patient’s experience, from preadmission to the point of registration to billing and collections. Recordings can be referenced for quality assurance, root cause analysis, staff training and for proof to ensure payment. Integrating voice data to the patient record gives providers a more complete view of the overall consumer experience and a reference to standardize patient financial communications across revenue cycle teams.
About The Author
Lindy Benton is CEO and President of Vyne™, industry leader in secure health information exchange and electronic healthcare communication management. Vyne’s solutions connect disconnected data to close gaps in documentation and improve the continuum of care through a more complete and fully accessible patient record. Outcomes include improved financial strength, operational performance and patient experience. For more information, visit vynemedical.com.