5 Ways revenue cycle can lead to better customer experience

"Give the lady what she wants," was the mantra of Marshall Field, the 19th century retail titan whose eponymous Chicago department store was world-renown for delivering outstanding customer experiences (CX).

Today, digital communication and service technology have opened a world of endlessly creative possibilities for CX built on many of the same innovations that Field pioneered 150 years ago, including identifying consumer preferences and offering transparent and consistent pricing.

Until recently, providers either put a low priority on CX or erroneously considered it to be one and the same with patient care. However, a combination of trends—ranging from high-deductible health plans to the ubiquity of holistic, digital engagement and communication—is altering how CX is perceived and implemented in provider organizations.

And you better believe that your patients are watching with a critical eye.

According to a study published in the Journal of Medical Practice Management, customer service is patients' chief frustration with their providers. Ninety-six percent of patient complaints are CX-related, citing inadequate communication and disorganized operations.

Providers can approach CX improvements in any number of areas within a hospital or practice, but the one with the most potential for the biggest impact is the revenue cycle. Here are five ways your revenue cycle is critical to outstanding CX.

1. Clear and Concise Billing
The proliferation of high-deductible health insurance has given patients more financial "skin in the game," but also increases the chances of providers dealing with bad debt. Many patients are discovering that they have become payers in a medical billing system that can be byzantine to even the most experienced healthcare professional. It's not unusual for patients to receive bills from multiple hospitals, doctors, labs or specialists for the same episode of care that vary in content, presentation and use of health industry jargon.

It may be quite some time—if ever—before medical billing becomes standardized, but there are improvements providers should consider making to their own billing statements. For example, is the bill's language clear and concise, with excess industry jargon removed? If you have an older population, are your font sizes large enough for easy reading? Are costs itemized? Does the bill have a section that details the insurance company's obligation?

2. Price Transparency
Healthcare price transparency is a laudable concept. Patients want it because they are contributing a larger share of the cost of care each year, through larger deductibles and larger out-of-pocket maximums. The stumbling block for providers is that accurate pricing of healthcare services is nearly nonexistent. Provider organizations negotiate prices with payers, but one side often has a disproportionate influence, and what individual patients pay depends on their insurance.

In April, Florida enacted one of the strongest state laws protecting consumers against surprise out-of-network medical bills. This law protects patients from surprise medical bills (exempt patients from having to pay balance bills from out-of-network providers in certain situations). The new law will apply to patients who go to a healthcare facility in their health plan network and inadvertently receive services from a non-network provider. Patients would only be responsible for paying their usual in-network cost-sharing. Oregon hospitals took a step toward improved price transparency Wednesday when hospitals promised to provide patients with cost estimates within three days of scheduling a medical procedure, reports The Oregonian. The initiative aims to give uninsured patients and those who are out-of-network a better idea of what the procedure will cost and prepare them for financial obligations. Each hospital in Oregon has agreed to provide estimates in three days.

By proactively addressing financial information and solutions regarding payment options, you can boost transparency, and help patients feel more engaged in their care.

3. Business-to-Consumer Approach
Providers are facing mounting pressure to provide revenue cycle processes that are more "retail" in design. One of the defining pillars of consumerism is that the patient is empowered by choice. How many choices do your patients have for scheduling or canceling an appointment? Are they able to choose their preferred communication channel? Are they offered payment options that work within your cash-flow demands?

Prior to a clinical encounter, providers should be able to assess a patient's insurance eligibility and financial responsibility, as well as determine their ability to pay what they owe. Make pre-appointment checks part of your standard workflow, coupled with a liability estimator, so you know how much to collect from the patient. Before they walk through your front door, your patients should know about payment options and financial assistance. This includes knowing which services are covered by their insurance, what their total financial obligation is going to be, and what your organization expects to be paid for the appointment.

4. Dedicated Patient Portal
Patient portals are ideal and automated tools for engaging and interacting with patients. Secure portals allows patients and their doctors to send and receive messages to each other; allows patients to view and update their accounts; view their doctor's billing practices and payment options.

5. Technology has changed the way consumers shop. Make it easier for patients to interact with you by leveraging current technology. Whether it's a smartphone, tablet or laptop, leveraging mobile technology to interact with your patients is key
When it comes to billing, patients have different expectations, practices, and preferences in how they pay. By utilizing technology and building more flexibility into your collections, you can reduce your reliance on paper statements and bill collectors, get quicker payments and reduce your administrative costs. Real-time adjudication and point-of-service collections with tangible and effective follow-up strategies are an absolute must for healthcare providers to interact with today's savvy patient-consumer.

Just as doctors and nurses have to engage and lead patients through difficult discussions about treatment, today's provider organizations are increasingly tasked with educating and communicating complex financial issues with patients. This is not an easy new reality for patients or providers. New tools and approaches, however, can simplify these interactions with clear and accurate information. Most importantly, they can instill a new sense of confidence in patients in their ability to pay for care.

Scott Herbst is Senior Vice President and General Manager of Provider Solutions at Availity.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.


Top 40 Articles from the Past 6 Months