Even though some of the health system’s facilities have a 50 percent Medicare and Medicaid payer mix, bad debt is less than 1 percent.
Providence Health & Services, serving more than 3 million patients each year, uses a centralized Customer Service Contact Center to support its 34 hospitals and more than 600 clinics in five western states. Teresa Spalding, vice president of revenue cycle, credits the call center staff for its role in the system’s revenue-cycle success.
“We are proud of our level of charity and how we manage bad debt,” Spalding says. “We have hospitals in many communities in which Medicare and Medicaid are more than 50 percent of our payer mix, but our bad debt is less than 1 percent [of revenues] and financial assistance typically runs about 3 percent.”
The customer service contact center handles about 100,000 incoming calls each month and staff make more than 100,000 outbound calls to address past-due balances. The staff includes 100 inbound agents; more than 50 outbound account resolution specialists; financial-assistance processing staff; a clinic financial counseling team; and a training/quality assurance team.
This is a sample article from HFMA’s Revenue Cycle Forum. Learn more and subscribe.
The customer service contact center staff are called “caregivers,” which reinforces Providence’s culture that Spalding and other revenue-cycle leaders seek to inspire.
“If you walk in our doors, it’s very vibrant,” says Kathryne Rouse, system director, customer support, with Providence. “We have our promise to our patients posted, which is “know me, care for me, and ease my way.’ And that is really built into how we train and empower our caregivers.”
Hiring the Right People
Customer service contact center success starts by hiring individuals who enjoy providing excellent customer service, Rouse says. “We can easily train caregivers on how to explain copayments, coinsurance, and deductibles and how to use our electronic health record system,” she says. “But the piece that is the most challenging to train for is customer service―having caregivers who genuinely and sincerely know how to express empathy.”
Pay strategy. The customer service specialist position is one of the highest paid entry-level positions in the revenue cycle department, Rouse says, because the work can be intense at times.
“You’re taking phone call after phone call, and people calling in aren’t always thrilled to talk to you because they have a bill. That is a hard position,” she says. “I believe we can recruit top-notch caregivers because we are very competitive in our market and have built a great work environment. Most of our new hires are referrals from other caregivers within our revenue cycle department.”
Interview strategy. While many healthcare call centers focus on typing skills or computer literacy when they evaluate candidates, Providence customer service recruiters use behavioral-based questions when interviewing candidates. For example, the following questions might be used to evaluate a customer service contact center candidate.
- Tell me why you chose this as a profession.
- What are some things you like about this type of work?
- What are some things that you dislike about this type of work?
- What have you found to be the best way to de-escalate an upset customer? When have you used this technique? Can you provide an example?
“We do make sure people are proficient in computer skills, but we really care more about how they are going to treat our patients,” Rouse says. “Do they have a heart for service? Are they going to live out our mission and values in the work they do and will that come through on the phone through the tone of their voice?”
Flexible Work Practices
Providence uses flexible work strategies to recruit and retain call center staff.
Working from home. A 2011 pilot in which five customer service contact center staff members worked from home proved so successful that it has expanded to include approximately 30 staff members―and has spread to several other revenue cycle units as well.
The practice is good for employee satisfaction and has also proven beneficial for the health system. For example, when winter storms made travel hazardous, Rouse used to worry about whether enough staff could get to work to answer the incoming calls, particularly during the extended evening hours. “By having our caregivers working from home, we can easily stay open to serve our patients,” she says.
Allowing remote work options reduces turnover among employees with specific limitations, such as allergies or mobility. “It’s really a benefit to allow those caregivers to work from home,” Rouse says.
Providence extends the work-at-home opportunity only to high performers. Customer service contact center staff are invited to work at home if they maintain a certain amount of calls per work shift with a high quality assurance score. They must also meet specific criteria, including having a secure location for work-related equipment and materials to comply with patient privacy protocols.
See related sidebar: Implementing a Work-from-Home Option for Call Center Staff
Recruiting college students. “Some of our best customer service representatives are students who are willing to work evenings and/or weekends,” Rouse says.
That’s why she reaches out to community colleges and universities, letting them know about student job opportunities and the qualities Providence is looking for. Rouse hires students for full-time positions, as well as for on-call or per-diem positions, depending on students’ schedules and the call center’s peak calling volumes.
Full-time employees are eligible for Providence’s tuition-reimbursement benefit. “College and university students are often looking for growth opportunities, and in the healthcare industry, there are lots of growth opportunities,” she says. “They may finish their bachelor’s or master’s degree through our tuition-reimbursement program and go on to analyst roles or managerial positions within the organization. It’s a great tactic to retain quality caregivers.”
Focus on the Patient
Providence works to recruit and retain top-notch Customer Service Contact Center staff as a way of carrying out the health system’s mission to be patient-focused.
“That’s how Providence’s revenue cycle is run from the top-down—it’s all about putting the patient in the center of everything we do and making sure their experience is a good one,” Rouse says. “Patients do have an amazing customer service experience because what we are looking for is primarily customer service skills.”
Lola Butcher is a freelance writer and editor based in Missouri.
Interviewed for this article:
Kathryne Rouse is system director, revenue cycle, customer support, Providence Health & Services, Portland, and is a member of HFMA’s Portland Chapter.
Teresa Spalding was vice president, revenue cycle, Providence Health & Services, Renton, Wash., until she retired from Providence at the end of 2016. She is a member of HFMA’s Washington-Alaska Chapter.
Forum members: What do you think? Please share your thoughts in the comments section below.
1. What is the training protocol for your organization’s call center staff members?
2. What has been your organization’s most successful strategy for hiring and retaining exceptional call center staff?