Communication
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Communication Case Studies |
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Communication between hospitals and their patients is extraordinarily complex. The healthcare landscape is littered with medical and business terminology and acronyms that are unfamiliar and may even be daunting to the vast majority of the population. These barriers, coupled with complex regulatory and payer requirements that often focus on how and when information is conveyed, often create significant communication challenges.
As such, high-performing revenue cycle hospitals place great emphasis on the effectiveness with which they communicate with patients and their families. Actions typically focus on supporting a positive scheduling/registration experience, providing estimates of financial obligation, publicizing financial assistance, developing clear and simple formats for billing materials, and establishing consistent external communications.
Supporting a positive scheduling/registration experience
One of the best ways to support successful communications with patients is to minimize redundant interactions. Many of the high-performing hospitals have streamlined processes by converting to centralized scheduling and/or registration for hospital departments where doing so offers efficiencies or potential for service improvement. Even in instances where scheduling and/or registration remain decentralized, effort is expended to ensure that patient information is shared by departments.
Also key is ensuring consistent messaging during these interactions. High performers frequently provide staff with scripting and monitor their conversations with patients for accuracy, friendliness, and overall appropriateness. Making scheduling and registration resources available in multiple languages also helps support standard communications.
Providing estimates of financial obligations
Efforts to enhance communications and service to consumers often focus on providing patients with estimates of their anticipated out-of-pocket expense prior to delivery of services. Although high-performing revenue cycle hospitals generally aspire to make this information available to patients through patient portals on their web sites, currently they provide these estimates to patients through a variety of communication mechanisms, including phone or mail.
Although hospitals and health systems increasingly are using average cost information for procedures or services to develop preservice estimates for those without insurance, most organizations still struggle with out-of-pocket cost estimation for the insured. Technology is aiding these efforts considerably, with some hospitals now able to apply (to a limited extent) a payer’s negotiated contract rate, deductible, copayment, and co-insurance percentage through automated means.
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Publicizing financial assistance
Also an important communications priority for high performers is educating patients and their families about charity care, early pay discounts, and other potential financial arrangements or resources prior to or at the time of service delivery. Ways some high performers publicize their charity care policies include posting charity care information on their web site, inside billing communications, and in brochures at registration desks. Further, a number of individuals throughout the organization have the ability to grant charity care to patients meeting predetermined criteria.
It should be noted that while all of the high-performing hospitals offer charity care, there is variation in how charity care policies are made available to potential recipients.
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Effectively Communicating the Organization’s Financial Services and Charity Care
A key element to clear revenue cycle communications is helping patients and families understand their financial responsibilities for care, and what services or programs are available to help them if needed.
Although community benefit commitments, including the charity care policy, should match what hospitals can afford to deliver given their financial capacity, providers’ focus within that capacity should be on helping patients and their families access and pay for needed medical services—and that includes ensuring those who need financial assistance receive it according to a well-published and supported charity care policy, as HFMA president and CEO Richard L. Clarke, DHA, FHFMA, notes in “Revenue Cycle: What’s It All About?”
Supporting clear and simple billing and collections materials
High performers place great attention on messaging and communication practices around billing and collections. Such communications can significantly affect a patient’s impression of the organization and overall service experience, and the patient’s willingness to promptly pay.
To improve consumer understanding of billing communications, high performers simplify their bills by removing acronyms, low-cost items, and nonessential details. Included with bills are letters of explanation that, among other things, discuss what the patient can expect during the billing process.
Staff use carefully crafted scripts and make resources available in the most prevalent languages to support consistency of interactions. Many high performers will also provide patient advocates, when necessary, to work with or on behalf of patients regarding payer issues. The objective is to resolve denials or other payment barriers that may affect patient financial obligations.
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Recognizing the importance of external communications
Messaging that occurs online and in print is particularly important to high performers. These messages often shape the community’s first impressions of the organization. Also, educational materials supporting business processes will stay with patients long after they visit.
At high-performing organizations, marketing and revenue cycle staff often collaborate to ensure brochures, billing communications, and online content are consistent in messaging and are appropriate and easy for readers to comprehend.
Web site content tends to be comprehensive. High performers often include charge and/or cost information for selected procedures (sometimes by payer), bill status, online bill pay options, and, in a limited number of cases, patient test results.
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