Reengineering the Patient Experience Through Standardization

From care delivery to technology and payment structures, changes in the healthcare industry have been vast and volatile. For physician practices, there is one area where change has carried the greatest significance: patient experience.


Since the days of the solo practitioner in the small town, the patient has always been the primary focus of the physician practice. Modern times have brought government mandates and dependence upon sophisticated technology, complex compliance regulations and other back-office challenges that can easily distract any practice from its focus on the patient.

What has changed more recently, however, is the responsibility of the patient as payer. The patient who controls more and more of his or her healthcare dollars expects more from those dollars, meaning more is expected from the physician practice. The physician visit is not solely about quality of treatment in the exam room, but about how well the patient is treated throughout the entire encounter with the practice.

Achieving a positive overall outcome for today's patient requires creating a standardized experience made possible through consistent, familiar processes deployed at key points within the revenue cycle. Standardizing processes throughout the patient encounter will drive patient engagement by eliminating stress for both practice staff and patients that is generated by typical roadblocks that impede success.

Pre-visit: Scheduling
The goal during the scheduling process is creating ease of entry for both new and returning patients. Returning patients, in particular, have a certain expectation for how the scheduling process will flow. Inconsistencies can be a source of disruption. For example, informing the patient of his co-pay and other payment responsibilities during one scheduling call, but neglecting to discuss such information in a subsequent call may lead to confusion or missed expectations during the encounter.

Patients also want to understand what clinical and insurance information they are expected to bring to the visit. Failing to request documents during the scheduling call and then requesting those documents during the visit leaves a bad impression, especially on new patients.

Practices can avoid such disruption and confusion and instead create a smooth encounter by training staff on appropriate processes when interacting with patients. If everyone is on the same page, so to speak, patient concerns are apt to be handled more efficiently and successfully; training also empowers staff with the ability to better educate patients on the practice's processes and financial policies.

For instance, practices should document the scheduling process and develop standardized scripts that staff can employ for new and returning patients. A script will enable staff to understand what is expected of them — what questions should be asked of the patient, the reminders the patient should be given -— and respond more effectively to patient questions. To reduce wasted efforts, the script should be clear and concise, including only those elements integral to the scheduling encounter. The scheduling call is also the time when the eligibility for services is reviewed and the need for pre-authorization is discussed.

The objective is to foster good customer relations, so patients will expect the same type of treatment at every encounter.

A summary of the conversation may end the call: "We"ll see you, Mr. Smith, on July 28th at 2 p.m. As we discussed, there's a $25 co-pay. You will need to bring a copy of your MRI results, and you'll also be asked to sign a HIPAA form. Do you have any questions?"

Standard procedure may also include sending welcome packets to new patients that include the practice's financial policies and a summary of the information/requests given during the scheduling call.

Visit: Check-in, check-out
The actual visit to the practice should elevate the level of comfort for the patient. Practices should extend a personal welcome to patients and focus on conveying consistent messages that leave little room for the unexpected. Again, the check-in and check-out process should be documented and then scripted so the staff does not leave out any pertinent information or essential element of the process—assuring coverage and securing payment, in particular.

A standardized check-in process should include gathering requisite information, such as insurance verification and pre-authorizations, and an explanation of any forms the patient needs to sign — or re-sign. Signing HIPAA forms for a second or third time can frustrate patients if they don’t understand why a current signature is necessary. This is also the time to remind patients of any payment that is expected at the point of service. Conversely, if patients neglect to bring a document or payment, practice staff should be well trained in the process for managing these situations.

Finally, the check-out process should have the patient leaving with a good feeling about the encounter. New appointments should be set and the patient should be asked about any questions or concerns. In keeping with the practice’s financial policies, request for payment on current and outstanding balances should be made either at check-in or check out.

The approach to managing patients at this critical point in the visit is integral to obtaining success in the patient experience. The consistency with which the practice staff is trained on processes and patient education will be reflected on how well they relate to patients and in turn how patients view the experience. Having patient service staff who excel in customer service and people skills is a real advantage. Skilled communicators can interact more easily with patients and focus even more intensely on educating patients on their financial obligations.

Post-visit: payment
Although many of the processes that follow the patient encounter are not directly patient-facing, they absolutely do affect the patient experience. These are back-office revenue-cycle management processes that, depending upon how they are performed, may either enhance or damage how the patient feels about the practice. Claims that are not administered correctly, payment postings that have errors, denials based on inaccurate information can all lead back to negative encounters with the patient.

If a patient mistakenly receives a request for payment based on an error somewhere within these back-office functions, the patient may question the quality of the practice or may choose to leave the practice altogether.

Likewise, those revenue cycle functions that do require direct interaction with the patient — explaining financial policies or collecting self-pay balances — should be managed in a structured way, much like the processes in the pre-visit and visit encounters. Patients, for example, should have easy access to the practice, such as through direct telephone numbers to patient financial services staff, rather than scheduling staff, so they can get their questions answered quickly and efficiently.

Overall, practices should strive to excel in providing good customer service and understand that this may mean focusing internal resources where they can used most effectively — directly with patients — and consider when it's best to use external resources for non-patient facing functions.

Preparing for change
As the responsibility of payment shifts more to the patient, and as the insurance process becomes more complex, patient expectations will change. As consumers, patients will both need and expect a greater level of service. Achieving patient satisfaction by standardizing processes can help to engender loyalty and trust; it will also help to secure the practice for a future in which patients will increasingly choose providers based on the experience — both in and out of the exam room.

 

© 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