AS I SEE IT
ance payers for offering discounts and write-offs to capture cases. Estab- lishing financial policies that reflect appropriate practices is the first step in ensuring that your business office is acting with the financial accountability of the facility in mind.
Customer Service Team In our ASC, we found that many patients were confused about their insurance coverage and identified key staff mem- bers that had the gift of education to speak with patients about their bene- fits preoperatively. Taking this approach allowed us to engage patients in a way that they were unaccustomed to when working with other health care provid- ers who routinely left the patients to fig- ure it out themselves, typically, after the fact and when the bills were due. Along with instituting a discussion of deduct- ibles, co-insurances and out-of-pocket maximum payments, we developed a script for requesting payment at the time of service and setting the expec- tation for payment of the balance. After discussing the day-of-service payment, patients were given the option to struc- ture their payment plans postopera- tively or pay the balance due after the facility received insurance payment. This proactive approach to educat- ing patients and deliberately discuss- ing payment expectations was received with open arms. A word of caution: be open to the
idea that teammates chosen for this role might not necessarily be exist- ing business office personnel. When selecting staff to take on this respon- sibility, it seems natural to think that someone with insurance verifica- tion knowledge or accounts receiv- able experience would be the right fit. Sometimes, however, your bubbly front desk receptionist, friendly reg- istrar or personable medical records clerk has more of the right disposition to both learn this skill set and teach your patients about their benefits.
them a total picture of their financial responsibilities.
Informing patients and setting financial expectations . . . before surgery led to . . . many positive outcomes.”
— Corrie Massey Sansum Clinic
Full Disclosure
When discussing our facility fees with patients, we had to navigate some haz- ardous community perspectives. Pub- lic demand for full disclosure of med- ical fees was flamed by media hype surrounding transparency in medi- cal billing and the fraudulent billing practices of a few providers. We found some patients wary of health care pro- viders in general and had to work hard to gain that community’s trust. As pro- viders, we know that the amount we bill insurance companies is rarely the amount we receive in payment. This was a fact we decided to share with patients who questioned our billing practices when we made these preoper- ative calls to discuss finances. In addi- tion, we tried to include estimates for all of the other providers we could— anesthesia, pathology, technical, pro- fessional and radiology, to name a few. Patients loved that we not only will- ingly approached them with their facil- ity estimates, but also worked to give
Outcomes As expected, our patient satisfaction scores related to activities involving our business office improved greatly. We received one negative comment about our new approach from a patient who simply didn’t want to know about any of the financial aspects of her care. That gave us the opportunity to enhance our script to include asking our patients how much of the informa- tion they want to receive. Some want a full explanation while others are happy with a simple dollar amount. Beyond these metrics, proac-
tively discussing anticipated expenses decreased both our accounts receivable days and the number of accounts in collections over time. Part of this can be credited to asking patients to pay some portion, if not all, of their esti- mated bill on the day of surgery. This process left smaller and fewer balances due postoperatively. In the end, initiating the discussion
of money—a conversation from which our office had previously shied away—was the most effective tool in improving outcomes in all of these areas. Informing patients and setting financial expectations was not something many of our patients had experienced from providers in the past. We were thrilled to find that opening those dialogues before surgery led to so many positive outcomes. We also had significantly fewer angry phone calls from patients after surgery about bills they received. Partnering with patients from both a medical and financial aspect was the right move to increase patient satisfaction and positively impact our revenue stream.
Corrie Massey is the administrator at Sansum Clinic in Santa Barbara, California. Write her at
corriemassey1@gmail.com.
ASC FOCUS MARCH 2015 11
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