The PFX Voice

Suzanne Lestina
Suzanne Lestina

Before patients even walk through your doors, they have expectations.

Those expectations cover everything from their treatment and recovery to what your facility should look like. One expectation that too often gets overlooked is how, exactly their financial experience with you will play out. Consider this — patients are conditioned from other industries to know their financial responsibilities up front (HFMA even advises them to be proactive in gathering this information). This means that if you want to foster a positive financial relationship and accelerate your cash flows, you must communicate in a timely manner with your patients.

 

Having productive conversations around these responsibilities and the financial experience overall requires a strategic approach, and specifically, one that prioritizes communication across all areas of your organization. The first step in achieving this is making sure that, from pre-service to final bill processing, your revenue cycle staff is as invested in the patient experience as any clinical department.

 

Understanding Cash Flow and the PFX

Refining the patient financial experience starts with the people who shape the beginning and end of interactions with your facility.

Take your access staff, for example. They may not understand where they fit in the cash flow equation. These positions typically fall on the lower-compensated end of the revenue cycle and are often viewed as a non-revenue-generating position. However, this staff is the face of your patient financial experience (PFX). Not only are they frequently the first point of human contact for your patients, they are also tasked with maintaining a broad understanding of payers and protocols and communicating this information to the patient.

Anyone working in this position should not only be aware of the essential role they play in a patient’s overall experience, but should also be trained in interpersonal skills constructed from a patient experience perspective.

Your staff should understand the responsibility they have in establishing clear financial expectations with your patients.

 

Assessing Your Current Situation

What does the relationship between your revenue cycle and clinical departments look like right now?

If this question is difficult to answer, it’s time to take a hard look at how these two areas at your facility interact. Chances are, you’re already having in-depth conversations about the patient experience and putting in the work to foster a more patient-centric approach. However, it’s also likely that the revenue cycle is not part of these discussions. If this is true, you’re missing a huge part of the patient experience puzzle — it’s simply impossible to understand the complete patient experience without a picture that includes what patients encounter financially.

Talk to your revenue cycle staff. Find out whether they feel as if they’re connected to the clinical experience and whether they understand how much impact they have on your clinical staff and how patients experience your organization. It may be that your front-end staff focuses on the day-to-day perspective and have possibly never been informed as to where they fit in a strategic plan to improve the patient experience.

 

Relating the Benefits of a More Effective Process

If you do have changes to make, gaining buy-in around a new approach from your revenue cycle staff can be challenging, but relating benefits can go a long way. Improving effectiveness by connecting your revenue cycle staff to an already patient-centered clinical approach can yield multiple benefits including a direct impact on cash flows.

Take the recent example of our client who moved their financial communications to pre-service. By engaging the patient prior to their service, they were able to identify unknown primary or secondary insurance that was missed at pre-registration, resulting in $500,000 dollars in insurance payments that would have been left on the table.  That’s an issue that can be avoided with solutions such as tailored messaging that encourages robust conversations with your patients.

Any organization that prioritizes addressing cash flows, especially in a time of increased value-based reimbursement, must also prioritize a new approach to revenue cycle management. Treating the financial experience as an organic outgrowth of the overall patient experience rather than one that’s divorced from clinical can completely change the way even the most basic patient interactions play out.

 

Moving Forward

Changes like the ones we’ve discussed require a top-down approach. Buy-in must come from executive leadership or managers and staff won’t follow. Once you’ve won executive support though, execution will be critical.

To address the points above on a tactical level, begin with a focus on reporting that gives insight into the breakdown of lost revenue or low patient satisfaction. The ability to leverage data to engage both revenue cycle staff and other key stakeholders will be essential to building a strategy that connects your staff to the patient experience.

Ultimately, acknowledge that you’re looking to implement full-on cultural change and that a shift in approach, while essential, takes time.

If making these changes in your organization is going to be a challenge, it may make sense to outsource some of these functions. A well-structured account resolution service can help you achieve your patient experience goals and improve overall cash flow. You can realize the benefits of increased patient satisfaction, reductions in denials and skilled financial counseling. Contact us today to find out how much more effective your Patient Financial Experience processes could be.

Regardless of the method you choose, keep your patients’ journey at the forefront — from pre-service, to clinical interaction, to final bill payment — and you’ll build a truly complete patient experience.

Topics: Patient Financial Experience, Pre-Service Financial Clearance

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