Dollars and Sense
How customer service improvements can help our bottom line
The health care landscape is changing, says David R. Morlock, senior associate director and chief financial officer at the Health System. Patients are paying more and more out-of-pocket health care costs. As a result, they want more than just good care. They want better customer service, too.
A big part of customer service involves helping our patients understand payment expectations – at the front end of their health care experience, rather than after the fact.
“Patients are often faced with multiple treatment options,” explains Dave Spahlinger, M.D., executive medical director of the U-M Faculty Group Practice and Senior Associate Dean for Clinical Affairs at the Medical School. “It’s our responsibility to help them understand the likely outcomes, effectiveness, and side effects of the varying options - and their costs - so patients can make more fully-informed decisions.”
“We want to focus our resources on the initial patient interaction, to improve service and make the patient experience better,” Morlock says. “An additional benefit to improving these patient interactions is that we'll enhance our patient financial information, which will allow us to be more effective in collecting the money we are rightfully due.”
An interdisciplinary team has been created that spans the entire Health System to design a standard process of educating patients about their own financial liabilities. The team’s effort is called the Patient Access and Financial Clearance project.
“Our patient care is great, but we also need to consistently prepare and educate the patient about what care is covered and where they are covered,” says Cindy Bodewes, director of reimbursements and business support, Ambulatory Care.
The end goal is to create a Financial Clearance Center. The center will ensure standard work, processes and accountability across the institution in all areas that perform parts of patient financial work. It will employ a combination of existing and new resources.
Bodewes explains that it’s not just uninsured patients who are getting surprised by large bills. The Health System also owes it to insured patients to understand how much a procedure will cost them and whether they would have lower out-of pocket expenses if they were treated elsewhere.
Five Health System areas are starting the process, which will ultimately be implemented system-wide. These early adopters are reviewing current financial practices and determining what they’ll need to connect the dots between point-of-service and the Financial Clearance Center.
The goal: to ensure front-line staff has the information patients need about the cost of their care.
“A patient financial clearance center will provide tools and technology so we can be insurance and payment experts,” says Benjie Johnson, director of Professional Billing, Faculty Group Practice. “This is an economic imperative for the Health System. Patients do want to talk about their bills.”
“Consumerism is changing health care,” Morlock adds. “People are paying for more care out of their pockets, and they are demanding better information and service on the business portion of their health care.”
The five early-adopters
Results from these groups will be applied to create standard processes across the Health System.
Written by Beth Johnson
"This is so important and I'm glad to see we are bringing the patients on board in this way. As an infusion clinic nurse, I am constantly asked about insurance approval and what the actual costs for current treatment are and I have no information on this subject. Presently, the only resource I have for referral is the patient billing line which frusterates patients as it's a voice mail system. This leaves them very anxioius and it takes forever for a return call. (Patient commentary) I hope there will be continous information fed to staff, such as myself, so that I can assist patients in this part of their treatment." Candace Saylor RN, 8A infusion room
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