Calling all revenue cycle managers, customer needs assistance up front

With the rise in high deductible health plans, many patients are beginning to assume increased financial responsibility and are shopping for healthcare services to find the most cost-effective options.

In addition, the Affordable Care Act has resulted in a growing population of first-time insured patients who are making healthcare purchasing decisions and need to be educated about the revenue cycle and their financial role in the care experience.

Given these industry changes, many hospitals and health systems are taking a closer look at the protocols and processes they have in place to guide financial interactions with patients. While patients do appreciate pricing transparency and advanced information about their financial responsibilities, there are several steps that are often skipped on the front end of the revenue cycle.

Customer service makes all the difference

The healthcare market is more competitive than ever, and providers are under pressure to offer affordable, quality healthcare, or risk losing patients. Just as in other industries, healthcare customers value quality service at competitive prices. They also place a premium on other factors that are often overlooked, such as convenience, atmosphere and predictability, as well as a knowledgeable and friendly staff. As such, it is important for providers to create a culture in which customer service and satisfaction are among the organizations' highest priorities.

Think of your own experiences as a customer. For example, is there a certain restaurant you prefer? Assuming that you like the food and it is reasonably priced, what are the other qualities the restaurant has that elevate it to the top of your list? Is it conveniently located? Is it clean? Is the food consistent? Are the people polite?

Now, overlay that thought process on your own revenue cycle. Assuming you can't control the cost or quality of a procedure, there are many other facets of the patient (or customer) experience that you can control. These include customer service hours, the appearance and atmosphere of the registration and waiting areas, the level of professionalism among staff, process consistency and communication, all of which contribute to the customer experience. As with your favorite restaurant, some customers may choose you over a competitor for many reasons other than cost.

Strategies for creating a customer-service culture

A customer-service culture can directly impact a hospital's patient satisfaction scores, and ultimately, its financial performance. Below are five strategies providers can implement to create and maintain this type of culture:

1. Incorporate a customer service skills assessment into the hiring process. Staff members with patient-facing responsibilities must communicate effectively with patients in order to leave a positive first impression. When hiring for these positions, you should assess candidates' aptitude and ability to communicate clearly, work with a professional and helpful attitude, and project empathy for patients and their families. In addition, patient communication should be a core component of staff orientation, as well as continuing education programs. It may sound simple, but smiling and making eye contact with patients can go a long way!

2. Ensure patient access staff understands the entire revenue cycle process. It is essential for patient access staff to be able to explain the revenue cycle process at a high level, so they can identify potential issues, as well as set expectations with and properly answer questions from patients and their families. Be sure patient access staff members know and can discuss revenue cycle policies and procedures that may apply to patients after discharge.

3. Set financial expectations in the same manner as clinical expectations. Prior to patients going into surgery or receiving any type of treatment, clinicians inform them about required preparations, potential side effects, recovery time, etc. This helps patients understand exactly what they should expect from their hospital stay. It is important for the revenue cycle staff to take a similar approach when setting expectations with patients about the financial component of their service. This includes educating patients about issues such as pre-authorizations, insurance billing, bills or notices they will receive in the mail, payment due dates and accepted payment methods.

4. Encourage collaboration across the revenue cycle. If front- and back-end staff members operate in silos, you may want to consider redesigning their workflows to enable more collaboration between the groups. Forming cross-functional teams to address denial issues is a good place to start. This will help promote education around the processes, streamline communication and allow the staff to incorporate necessary changes to patient access and communications based on the issues identified.

5. Put yourself in the patient's shoes. It can be easy for healthcare employees, including revenue cycle staff, to forget that patients are not aware of and may not always understand the processes that make up the revenue cycle. Those in the healthcare field tend to use acronyms and other terms that are unfamiliar to patients, and patients have to decipher this information while facing potentially serious health issues. It is important to recognize this knowledge gap and explain healthcare billing jargon to patients in layman's terms so they understand how their finances are affected.

Making the customer-service culture a reality

Shifting to a customer-service culture requires healthcare organizations to make changes across the revenue cycle department that can result in significant improvements in customer satisfaction and lead to increased business. It is important for leaders to keep this shift in mind when creating staff training programs, making IT investment decisions, and designing both operational and technical processes. This will allow providers to deliver care and conduct business in a more patient-centric way, so they ultimately can succeed in the new value-based healthcare environment.

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.​

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