Some random thoughts on the physician medical office

March 9, 2018

Provide comprehensive training. Just like a football team undergoes rigorous training before it steps onto the field for a game, your revenue cycle staff should receive robust orientation and continued education to encourage the best performance every time they come to work.

When orienting new staff, the human resources department can certainly provide an organizational overview, but new staff members should meet with every department to get further insight into all aspects of the organization. Training on roles and responsibilities should be hands-on and involve real-world scenarios.

One especially beneficial training method involves shadowing an existing exemplary employee. Not only does this allow the new person to see what top performance looks like, but he or she is able to ask questions and receive answers based on best practice.

When offering any kind of training, whether it is new staff orientation or annual refresher courses, cross training is important. This helps everyone appreciate the complexity of the revenue cycle and how one function relates to and impacts another. Staff can easily see how underperformance or changes in one area can negatively affect others, which lays the foundation for more collaborative problem solving and process change. This also limits finger pointing when an issue emerges.

In addition to training, leaders should engage in regular communication with staff. Department leaders should frequently check in with their employees to get a sense of what’s going well, but more importantly, what’s not and what needs to be changed. It’s essential during these conversations to actively listen and respond to staff concerns. Listening without action won’t yield positive results and may build resentment.

Incentivize performance. Many organizations find that providing specific incentives can drive performance. For instance, an organization may wish to offer staff a monthly or quarterly financial bonus where staff would receive additional compensation if they brought in patient and payer revenue above a certain pre-established level.

Even if an organization offers a non-financial reward, it can be beneficial. For example, organizations may allow high performers to work from home, have relaxed dress code days or earn a free day off. Sometimes a gift card can be motivating as well.

Increase the value of the front-desk position. The front-desk is becoming increasingly vital to revenue cycle success as it plays a key role in driving cash collections, preserving patient satisfaction and ensuring responsive customer service. For all intents and purposes, this is the first exposure a patient has to your organization, and if the experience is not positive, it can have long-term damaging effects.

Historically, front-desk staff positions have been entry level and relatively low-paid. The individuals in these jobs may not have deep experience in customer relations and might struggle to navigate patient problems and concerns. Leading organizations are rethinking how they staff this position, focusing on hiring people with problem-solving and customer service experience and skills. They are also looking for individuals who are comfortable with multitasking and can simultaneously manage requests from internal departments, patients arriving for appointments and customers who have billing questions. Some of these constituents may be difficult to handle, so conflict resolution skills can also be helpful.

As organizations seek out staff that have high-level experience, they should also explore the possibility of increasing the front desk position’s compensation

Examine current workflows. Before you can make any process improvements, you need to get a sense of your existing way of doing business. Do your workflows make sense? Is there duplication? Are there things that could be done more efficiently? Are there any bottlenecks or backtracking in your processes? Are there risk points that require attention?

After getting the answers to these and other questions, organizations should craft detailed policies and procedures to close any gaps. A multidisciplinary group may be helpful in crafting these policies and procedures to ensure all perspectives are considered.

Define, collect and respond to performance metrics. The final score of a big game is a good indicator of how well a football team played. Likewise, key revenue cycle metrics can highlight whether front desk and billing processes are on target.

When determining which data to collect and review, make sure to choose quality measures and not just process metrics. This will give you a clearer picture of organizational operations and improvement opportunities. Check that metric definitions are consistent across the organization and everyone understands what a metric represents. There should be realistic but challenging performance targets, and as mentioned before, it can be beneficial to reward performance that exceeds these targets with monetary or non-monetary bonuses.

Provide cost estimates. Increasing transparency is crucial when trying to cultivate patient satisfaction. Nowhere is this more important than when communicating about how much care and treatment costs. Patients are interested in receiving upfront information about what they will owe, but they may not always know an estimate is available. As such, staff should be proactive in giving patients this information. Since you don’t want to slow down the registration process by having patients wait for their estimate during registration, it may be more appropriate to share the information 24-hours prior to the visit when possible.

Explain coverage. Paying for healthcare can be confusing for anyone—not only because of its complexity but also because the patient is usually under some degree of stress and may not be fully aware of what’s happening. A compassionate yet informative explanation of benefits and coverage can mean a lot to patients and yield more payments as well, as patients could be more willing to pay if they fully understand exactly what is included in the bill. To that end, building time into front desk processes to foster these conversations is critical.

Offer convenient payment options. Patients are used to being able to quickly and electronically pay for services in other areas of their lives. They are starting to expect this level of convenience from their healthcare providers, as well. This may take the form of online or web-based payment, credit card-on-file solutions or automated payment plans that spread manageable payments over time and automatically charge a credit or debit card.

Find solutions that meet you where you are. Not all revenue cycle technology offerings are the same, and it’s important to determine what types of products will help you reach your goals without having to revamp all of your business processes. Look for intuitive products that are flexible in nature and that take your existing practices and procedures and make them more efficient, timely and accurate. Also, make sure that any new solutions are compatible with your other technology, such as electronic health records and practice management systems.

New technologies, such as credit card on file, are viewed by providers as the best way to improve patient payments. Patients are on board, too! In fact, 78% of patients surveyed in 2017 said they would provide a card on file to pay balances less than $200. 

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