How to address 7 common RCM customer service mistakes

Patient satisfaction is a key focus for hospitals and health systems, as it is considered one of the top indicators of the quality of an organization. And in today's healthcare environment, revenue cycle management and patient satisfaction are closely intertwined.

Medical bills are often muddied with legal jargon and complex terminology, leaving patients confused about how much they owe. Patients may also have difficulty getting answers to their billing questions.

All of these things can cause patients to give the hospital a bad review online.

A study by healthcare marketing and management firm Vanguard Communications that examined nearly 35,000 online physician reviews found that a total of 5 percent of one-star reviews and 2 percent of two-star reviews of healthcare providers specifically cited billing charges as a reason for their dissatisfaction. Additionally, 96 percent of one- and two-star reviews cited communications as the cause of their complaints.

"As in other areas, our research finds that healthcare consumers are not as upset over core issues — e.g., a late doctor or lack of parking or what they were charged in their co-pays — as they are over a perceived lack of information about those issues," said Ron Harman King, CEO of Vanguard Communications. "Patients often accept relatively minor inconveniences such as distant parking or tardy doctors as long as they are forewarned and/or updated promptly."

Becker's Hospital Review recently spoke with Scott Gunther, senior vice president of global operational development at RCM solutions provider Navigant Cymetrix; Mark Klaus, vice president of operations at Navigant Cymetrix; and Mr. King about the connection between RCM and patient satisfaction. Here, they outline seven customer service mistakes hospitals make, and address how hospitals can overcome these issues.

Mistake No. 1: Focusing solely on operational experience

Everybody in the organization — including the CEO and RCM staff — must be committed to superior patient service in the revenue cycle. A hospital that provides a quality operational experience won't achieve superior patient service if staff and executives aren't committed to the patient experience.

"There must be a unified message and a single drumbeat that hospital employees can apply to their day-to-day service efforts," Mr. Gunther says. "All the best technologies, processes and best practices typically don't find the success they're looking for if there is not truly a unified patient experience direction."

He says "a unified patient experience" involves understanding patient vulnerabilities and other service standards, particularly during the medical debt recovery process and when communicating with patients.

But Mr. Gunther noted that superior patient experience in the revenue cycle is not easy. Patient experience derives from many departments and many people across the continuum of care, making it difficult to get people within a hospital to agree on a course toward superior patient experience, and how to fulfill that course, consistently.

Mistake No. 2: Failing to understand the patient population

Hospitals see patients who are baby boomers, Gen X and millennials, and it's important organizations understand distinct differences in what these generations want and don't want in their patient experience, according to Mr. Klaus.

For instance, millennials often like automation. They want to be able to look at their billing statements — and pay what they owe — using their mobile devices. In contrast, some baby boomers may not have a computer or iPhone. They want a manual revenue cycle process — to pick up a phone and talk to somebody.

Therefore, hospitals must respond to each population's preferences. "You're going to have a mix of all three [generations], so you have to do it right. You have to staff appropriately and you have to have it where it's automated and manual," Mr. Klaus says.

He also noted that millennials may not take the time to complete a patient satisfaction survey, whereas retired baby boomers may be more apt to reveal their opinions.

Mistake No. 3: Failing to get patients' feedback on billing statements

In designing a hospital bill, organizations must consider what information they can put on a statement, what they can't put on a statement and what is required on a statement. They must determine what the optimum bill would look like, and what kind of bill would give the hospital the greatest chance of collecting from patients. Mr. Klaus encouraged hospitals to mock up four or five statements, and then reach out to patients and ask if they like them. "So again engaging patients and figuring out what they like, what makes it easy for them [to understand and pay their bills]," he says.

It's also important for hospitals make sure patients understand their bills. To reduce confusion, Mr. King suggests hospitals provide a website link or mini dictionary with patients' bills that explains the meaning of jargon on the bill.

Mistake No. 4: Limiting the after hour phone options

Many hospitals close the business office at 5 p.m. When a patient calls after 5 p.m., they are told to "call back during normal business hours." However, millennials are getting home from work in the evening, so shutting the phone payment system down at that time is frustrating to them, Mr. Klaus says.

Mistake No. 5: Failing to adequately manage RCM vendors

Many organizations will outsource pieces of the revenue cycle. Hospitals should understand if they're only outsourcing the back end, which includes collecting patients' payments, they should be entrenched in the day-to-day operation of that vendor and to ensure the vendor is meeting the hospital's patient experience expectations, Mr. Gunther says.

He also noted that hospitals with various RCM vendors can easily lose the common thread or tether to a successful and sustainable patient experience.

Mistake No. 6: Sending additional bills after the patient already paid

Mr. King has seen, through his own experiences as well as in talks with friends and colleagues, that redundant billing is an issue. Redundant billing takes place when the patient has paid their bill, but continues to receive statements.

The result of redundant billing, he says, is unhappy patients who call or write or email the hospital to try to sort out their billing issue. "That takes patients' time. That makes them more upset. It motivates them more to go online and say bad things," he says.

Mistake No. 7: Failing to make it easy for patients to have their billing questions answered

Mr. King also has noticed patients spend a lot of time finding the right person to answer their questions about bills. "They'll talk to one person who knows some of the answers and then that person will hand them off to someone else who supposedly knows some of the answers," he says. "And we do see remarks [about] how patients feel like a dog chasing his tail. They can never find somebody with all the answers who can give them the straight scoop."


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