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Empower Your Patients' Financial Experience (ePFX)

Improve Patient Liability Resolution

UNLEASH THE HERO IN YOU!

Gain a better understanding of what's driving your patients' satisfaction during liability resolution so you can engage and empower their experience holistically from the first engagement until the last.

Explore the essentials, unique features and answers to frequently asked questions about ePFXscore, ePFXpredict and ePFXcoach. These unique business intelligence technologies and training are just a few of the many valuable additions we include with each of our financial clearance, early-out and bad debt patient liability services to achieve peak results.  

Essentials

Creating the ePFXscore began by analyzing key revenue cycle drivers of patient satisfaction or dissatisfaction.

Using real patients and guarantor’s data from 300+ nationwide hospitals, our data scientists have toiled and tested over 60 theories and revenue cycle urban legends of what drives patient satisfaction. It has been our own version of Myth Busters, revenue cycle style.

Then analyzing over 100,000 patient satisfaction surveys that follow calls in our engagement centers and countless hours of patient conversations through behavioral analytics our data scientists have uncovered statistically relevant and profound ways to turn around patient satisfaction so it positively impacts the revenue cycle and patient engagement.

Ten drivers initially stood out as providing the highest statistically valid and relevant impact on the patient satisfaction. Learn more about measuring and scoring criteria.

FEATURES

Ten drivers initially stood out as providing the highest statistically valid and relevant impact on the patient satisfaction. These drivers focus on these 3 categories:

Timeliness and Accuracy of Processing of Accounts Prior to Placement

The revenue cycle is long and complicated. It contains many handoffs and potential timing delays which can impact the processes and technology that are further downstream. The complaints and challenges described by patients often have a root cause that occurs long before a patient receives or makes a phone call to a healthcare provider’s customer service call center.

Status and Processing of Balance After Insurance (BAI) Accounts

BAI accounts often have some of the highest reimbursement rates for the patient balance that remains after the insurance portion of the claim has been resolved. These balances are typically deductibles, co-pays, and co-insurance amounts. Patients with BAI balances are often anticipating that they will have a balance that they will owe following the resolution of their insurance. Insurance companies send the patient Explanation of Benefit (EOB) documents that confirm the insurance company’s understanding of the patient’s liability or balance.

We have found patient satisfaction is negatively impacted if we receive a placement of an account that shows as a Balance After Insurance, but there are no adjustments or payments from the insurance payer.

Why it’s Important

It stands to reason that a patient who has insurance has a certain expectation that their insurance is going to make a payment and the patient is only going to owe a deductible, co-pay, or co-insurance. BAI accounts that are placed with us that do not have an adjustment or placement typically mean that the amount being billed to the patient equates to the full charges or some amount much higher than the patient is expecting.

Hence, the patient is immediately upset to receive a bill that is well beyond the amount they were expecting. These patients often place calls to the hospital’s customer call center to inquire about the balance they have been billed and are typically upset to receive such a large bill.

These types of accounts usually point to a problem with the individual account, with the processing of accounts for this insurance payer or a system problem in processing third party insurance accounts.

Identifying the root cause of insurance accounts being processed without payment is important to prevent future patients from encountering the same type of issue. Also, these types of accounts can create challenges for providers and their insurance companies.

We have found that patients not only make a call to the provider, but also to the insurance company. If the provider is not appropriately processing the bills associated with insurance companies or an individual insurance company, the insurance company might take note of these challenges and use them as leverage during contract rate negotiations or use this information when developing their provider networks.

Age of Account at Time of Assignment

The age of accounts when they are placed with an early out or bad debt partner has a significant impact on patient satisfaction. We have found that the older an account has aged from discharge or last charge date, the more negative an impact is felt in patient satisfaction.

When accounts are placed with an early out or bad debt partner, typically the first action taken by the partner is to mail or electronically send a statement to the patient. If this statement is 6 months, a year, or multiple years following the services provided, patients tend to become very frustrated and upset. Receiving an untimely statement says to the patient that the hospitals process and systems are broken. No one enjoys the surprise of finding a bill in the mail they were not expecting.

Why it’s Important

Aged accounts placed with early-out or bad debt vendors typically indicate that there was either an issue in processing this account or there is a more systemic issue with the processing of accounts. As each step in the revenue cycle is related to the previous and subsequent steps, there are many places where the process or technology can break down. Here are a few potential root causes of where these breakdowns might occur:

  1. Issues with the initial collection of data during the registration / admissions process
  2. Inability to generate a bill or patient statement
  3. Challenges with the processing of insurance accounts
  4. Problems with generating placement files for early out / bad debt partners
  5. Manual or automated holds placed on individual or groups of accounts

Communication between a provider and their early-out / bad debt partners can help to identify these accounts where accounts appear to be aged prior to placement. Early discovery of these accounts is important to the timely identification and resolution of root causes creating placement timing issues.

Amount of Patient Liability

We have found that the amount owed by a patient can affect the patient’s satisfaction with the provider. Based on analysis of the 100,000 patient satisfaction surveys, there is a correlation between rising account balances and declining patient satisfaction scores. The more we owe, the unhappier we tend to be.

Why it’s Important

The amount owed by a patient has many drivers. One patient might owe more than another patient due to the differences in the services received, their insurance coverage (or lack thereof), processing of the insurance portion of their bill, whether or not the provider was in or out of network, and so on.

Our statistical research has found that previous account demographics and statistics are a good predictor of future account performance. For example, providers that performs certain services or are located in communities with certain socio-economic dynamics tend to drive patient account balances. If a provider performs high cost or elective procedures, they often have patient balances that are higher. If a provider registers more patients without insurance or with insurance that has higher deductibles or co-pays, patients’ balances are often higher. We have found that additional education to patients, communicated prior to service regarding the liabilities they will owe, helps to mitigate the negative patient satisfaction with receiving a high dollar bill.

Timeliness of Payments on Accounts

Similar to the items described above, the timeliness of processing accounts has a significant impact on patient satisfaction. We have found that patient satisfaction declines when the initial payment on an account is delayed. The first payment could be from an insurance payer or a patient. It’s not the type of payment that drives the patient satisfaction impact, but rather the timeliness of any payment. When payments are delayed, it often implies an issue with the clean processing of accounts through the revenue cycle.

Why it’s Important

This indicator is important because it again speaks to the timeliness of processing accounts through the revenue cycle. If the first payment on an account is aged beyond comparative well performing revenue cycles or similar accounts within the accounts receivable of a single provider, it typically points to issues within the billing, claims processing, or account migration through a business office. Delays in initial payment often mean that an insurance company’s payment is late due to processing or denials or the patient has postponed paying on their account. When patients delay paying, it is often because they do not agree with the amount they owe or they are unable to pay. Either way, this has a negative impact on the provider’s cash flow and timely processing of accounts receivable.

Call Center Performance

For many patients, the last contact they will have with a provider related to their healthcare experience is in their dealings with the provider’s customer call center. The Patient Financial Experience delivered by the provider’s customer call center is often the determining factor in the patient’s overall satisfaction and perception of the provider. As the last point of contact, the customer call center can heavily impact a patient’s loyalty to a healthcare provider. The call center’s interaction with a patient while following up on a $500 deductible can protect or put at risk millions of dollars of revenue related to that patient and their family.

Volume of Accounts Routing to Bad Debt

Healthcare providers and their early out partners typically agree on a communication campaign they will follow for each patient account. For example, a common communication campaign for early out partners is to send a series of three or four patient statements and to place two to three calls to a patient over the course of several months. If the outcome of that call campaign is that a patient cannot be contacted or the patient is unable to pay/refuses to pay, that patient account is typically sent to a bad debt collection agency to further pursue resolution of the patient’s liability.

We have found that where a healthcare provider has a higher percentage of accounts transitioning from early out to bad debt, the provider’s patient satisfaction scores tend to decline. This business intelligence tells us that providers who are sending more patients to bad debt collections as a percentage of their overall patient liabilities tend to have lower patient satisfaction scores.

Why it’s Important

A higher volume of accounts transitioning to bad debt is often an indicator of processing issues in the revenue cycle, a challenging payer mix for the provider, or community socio-economic trends that drive higher bad debt. While some of these items might be out of the control of the provider, it is important to understand the root cause and impact of higher percentages of accounts transitioning to bad debt.

With higher bad debt percentages, we encourage providers to revisit their charitable care policies and patient discount policies. By updating these policies, we have found that providers can demonstrate they are delivering additional community benefit through their charitable write-offs or help their early out vendor to collect additional monies through the use of aggress discounting strategies. After all, in the case of patient liability collections, sometimes collecting some money is better than collecting no money at all.

Volume of inbound calls to placed accounts

Early out and bad debt partners can often predict the volume of inbound calls based on the volume and type of patient statements sent to patients. We have found that some of our healthcare provider partners drive higher volumes of inbound calls. This is in comparison to competitors or similar healthcare. Our data scientists have demonstrated that higher percentages of patient calls have a negative impact on patient satisfaction. As more patients call in for a specific provider, that provider’s patient satisfaction scores tend to dip in direct proportion to the percentage and volume of inbound calls received.

Why it’s Important

Higher volumes of inbound calls from patients typically indicates that patients have questions about their bill or they disagree with the information contained on the bill or statement. Once again, the root cause of these patient calls can be from processing issues further upstream in the revenue cycle, patient statements that are not patient-friendly in their design, or a host of other root causes.

We encourage our partners to work with us to better understand the root causes of why patients are calling in and to look for account indicators that seem to be driving patient inquiries. For example, do more patients with a particular insurance coverage call more frequently or are patients that received specific services more likely to call. Over time, we have transitioned from manual tracking tools to more automated call root cause calls. These automation tools are delivered through speech analytics capabilities. More on speech analytics below.

Call Center Performance Metrics

Performance metrics within a call center can also be key indicators of patient satisfaction. Patients who wait on hold for extended periods of time, who are placed on hold during a call, or have extended overall call times tend to have lower patient satisfaction scores. While we have often assumed that certain call center performance metrics were indicators of patient satisfaction, we now have the empirical evidence to show the correlation between call center key performance indicators (KPIs) and patient satisfaction.

Why it’s Important

No one likes to place a call into a customer service call center and end up waiting on hold. It is important for call centers to be transparent with their partners in sharing performance statistics. These statistics can indicate staffing issues within the call center, increased volumes in calls, balancing challenges amongst call center teams, call center technology challenges, and a host of other potential call center improvement opportunities.

Volume of Returned Accounts

Similar to the description above of accounts transitioning from early out to bad debt, another common disposition of accounts is when the early out partner has to return the account from the partner’s inventory back to the healthcare provider’s inventory. Accounts are returned to a healthcare provider from an early out partner because they were placed in error, there is an error on the account that needs to be resolved and the early out partner cannot resolve the account issue, and host of other reasons. As a higher percentage of accounts is returned from the early out partner to the healthcare provider, we have seen a reduction in patient satisfaction scores.

Why it’s Important

As more accounts are returned to the healthcare provider, it typically indicates that there is either a data or processing issue with the account. As the percentage of accounts continues to grow, we have found that there is a greater likelihood of systemic processing issues with the healthcare provider. As more systemic issues are discovered, patients are more likely to receive erroneous information on statements or statements that have timing challenges – ultimately resulting in patient satisfaction declines.

Speech Analytics

The latest technology enhancement driving changes through the Patient Financial Experience is the introduction of Speech Analytics. For early-out and bad debt partners, speech analytics provides tools to analyze and scrutinize every word of every call. Where quality assurance programs were once very manual and covered a small percentage of calls conducted by call center staff, speech analytics provides us the opportunity to review every call, without subjectivity, and consistently across a full population of team members and calls.

In addition, speech analytics identify and score specific speech triggers spoken by patients. This includes individual words and phrases of words. This also includes the ability to analyze word phrases in context of the call. For example, did the patient indicate that they are calling on this issue for the first time or that they are calling regarding this issue on multiple occasions? Did the call center team member demonstrate empathy? As it is only possible to show empathy if a patient has spoken words of discontent or dissatisfaction, speech analytics can only recognize empathy as it follows specific words or phrases spoken by a patient.

Speech analytics provides customer call centers with the first opportunity really score the Patient Financial Experience. With a Patient Financial Experience score (ePFXscore) we are able to identify areas of opportunity to deliver a better Patient Financial Experience, protect current and future provider revenue, and address any customer call recovery issues in real time.

How Speech Analytics Work

For every recorded call, the speech analytics tool automatically creates a call transcript. We anticipate this year that we will record and transcribe over 150,000 hours of calls. This will include over 1.5 billion words.

Once the calls are transcribed, we use artificial intelligence tools to apply hundreds of rules against each word and phrase in every call. With those rules, we can confirm the appropriate phrases and actions are performed by call center staff and we can monitor the patient’s discussion to identify negative or concerning interactions. In addition to transcribed calls, we can process any other written communication through the rules engine – tweets, emails, surveys, letters, etc.

By comparing the speech analytics triggers and scores to over 100,000 patient satisfaction surveys, we have identified specific triggers and scores that tend to have the greatest impact on the patient satisfaction surveys. For the first time in healthcare, we can provide feedback on how the patient feels about the healthcare provider and their Patient Financial Experience.

As Maya Angelou stated, “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” We can now provide feedback on how our healthcare provider partners and our team members in the call centers are making patients feel.

Specific Speech Analytics Triggers and Scoring [Negative Speech Analytics Triggers]

As described above, speech analytics provide the ability to apply rules to each spoken word and phrase included in calls placed or received by customer call centers. This also includes the ability to apply these rules to any written communication to or from patients. Our speech analytics tools automatically create a transcription of each call. As the calls are recorded in stereo, with the patient recorded in one channel and the patient service representative recorded in a separate channel, we can easily apply rules to either the patient or representative or to both.

As we’ve compared the various speech analytics rules to over 100,000 patient satisfaction surveys, we have identified a series of triggers that correlate with reduced patient satisfaction. If any of the following speech analytics rules are triggered, our data scientists have been able to identify a significant reduction in patient satisfaction. Of all of the criteria identified to negatively impact patient satisfaction, the triggering of these speech analytics triggers has the most significant impact on patient satisfaction. As a result of these statistical findings, we tend to weight the impact of these speech analytics greater that the other ePFXscore criteria.

Speech analytics triggers demonstrating the most significant impact on patient satisfaction:

  1. Call Emotion
  2. Agitation
  3. Dissatisfaction
  4. Escalation
  5. Legal Action Mentions
  6. Profanity
  7. Risk & Abusive Language

Why it’s Important

The introduction of speech analytics marks a substantial leap forward in our ability to monitor and improve the Patient Financial Experience. Previously, a negative call center interaction was difficult for management to find and address. It often required a patient services representative to contact their manager and identify that a call had just gone poorly. Many patient services representatives might be hesitant to do so as they would know their performance on that call would be heavily scrutinized.

Another way to identify calls that have performed poorly is a result of receiving a complaint or escalation from the patient. Invariably, whenever a patient complains to the healthcare provider’s leadership team, all calls are retrieved and reviewed. Lastly, some negative calls might be discovered through the archaic quality assurance process of randomly sampling and reviewing calls.

Speech analytics provides an opportunity to review all calls, all phrases and all words spoken. Not only does this automate the identification of calls where a patient has had a negative experience, it also facilitates an opportunity to implement customer service recovery protocols and to predict those patients who are most likely to escalate.

Speech Analytics Indicating Patient Will Not Pay

Speech analytics can be utilized to identify very specific words or phrases spoken by patients during their interaction with patient services representatives. We have identified that the specific words and phrases spoken when the patient will not pay has a significantly negative impact on the patient’s financial experience.

A patient cannot or will not pay for any number of reasons, but we have found that when a patient speaks words indicating they will not pay, those accounts have disproportionally lower patient satisfaction survey scores..

Why it’s Important

Utilizing speech analytics to identify patients who will not pay is important for several reasons. A patient sharing their objection to pay or inability to pay provides for further research and discovery related to "why?" These root causes can identify issues with individual accounts or more systemic issues across the revenue cycle. We can utilize manual tracking and additional speech analytics rules to diagnose the root cause of why a patient cannot or will not pay.

For example:

  • Is the patient sharing that they do not have the ability to pay?
  • Is the patient challenging the amount owed?
  • Is the patient challenging if they owe the full amount?
  • Is the patient sharing concerns with their clinical care or some other issue that occurred during their interaction or services with the healthcare provider?
  • Is the patient sharing that they don’t understand something about their bill or what they owe?

The identification of the root cause is the first step in resolving the patient’s challenges and obtaining payment. This may also help move the account to the next step in the revenue cycle process. For example, should the account be forward from early out to bad debt collections? This provides the healthcare provider an opportunity to assess and decide if the patient will receive additional statements, phone calls, or other communications.

FAQs

So, why can’t I just rely on my patient satisfaction surveys?

The challenge with patient satisfaction surveys is that they provide a false sense of completeness and comprehensive feedback. We have found that less than 6% of callers to our call centers complete a patient satisfaction survey and the survey feedback we do receive tends to be skewed toward the polar ends of the feedback spectrum – it was the best or worst experience ever.

No one would argue that the understanding and calculation of patient satisfaction is an inexact science. No two patient financial experiences or expectations are exactly alike. Relying on HCAHPS Surveys that measure the clinical engagement lend little in data, often reflecting the best and worst service spectrum and completion rates of HCAHPS surveys nationwide pale at less than 30%. Post-call surveys also net limited results. Less than 1 out of 20 financial surveys are commonly completed. That often leaves you measuring your patient satisfaction based on net patient revenue or gut instinct. None of which are adequate indicators alone.

I have invested in portals, apps and call center technology, how do I know I am doing a good job?
In today’s complex healthcare delivery models your patients are engaging with you in ways that we have only recently begun to operationalize let alone quantify. As we leverage new tools and technologies to move into this brave new world of consumerism it is imperative to your success that you have a clear line of site to what your patients are experiencing, regardless of how they choose to engage with you and your teams.
I have invested countless hours and resources in my patient financial engagement strategies, why am I not seeing results?
There is no doubt that you and your teams have invested an unmeasurable amount of effort and leveraged many of the tools available in the market to create the best patient financial experience to your patients. And in many ways, you are likely seeing positive results in the limited number of metrics available to you to measure your results. But with that said, there is a nagging question of, ‘How do I know for sure?’ I am still seeing complaints on Facebook, my executive team continues to receive escalations, or maybe worse, my census is down year over year and I cannot explain why. With the many variables in the equation coupled with the fact that your patients have more choices than ever regarding their health care, it is critical to completely understand the experience you are providing, be able to quantify, track and trend the variations and ultimately continually look for areas of improvement. Only with visibility to 100% of patient engagements and a proven methodology to scoring those engagements, will you be able to provide the world-class experience your patients are demanding.

ESSENTIALS

The future is by its nature an uncertain thing. We tell stories of crystal balls and fortune tellers foretelling the future, but rarely can we actually predict what is to come with any certainty or consistency. This is especially true when it comes to predicting human actions. Although, when we leverage tools that have statistically proven to predict patient satisfaction, perhaps we can also predict patient actions.

The most dreaded of all patient actions is the complaint to hospital or health system senior leadership. It is interesting that in our business of early out and bad debt collections, it is rarely our performance related to collecting monies or our cost that is the greatest determiner of our client’s satisfaction with our performance. More often than not, it is the volume and ferocity of patient complaints that will dictate how a health care provider views our services. When asked about our capabilities and regarding whether or not a health care provider will be a reference for us to other health care providers, our clients often begin their response with an assessment of our generation or impact on patient complaints.

Not only are patient complaints a challenge to both the health care provider and the early out or bad debt vendor, complaints are almost always handled in a reactionary means. It is only after the complaint has been issued to the health care provider that the provider or the vendor jump into action to address the issue. This is often handled via a flurry of email requests for call recordings, multiple people reviewing the calls, assessments of the patient’s demeanor and language used, and reflection on how the patient services representative handled the call. All the while, looking at the situation in the rear-view mirror following the train wreck after it had occurred.

If only there were a way to predict which patients are most likely to escalate and to prevent or at least prepare for those escalations. Leveraging the muscle of speech analytics and the power of each patient’s words, we now have a means of predicting which patients are most likely to escalate or file a complaint with the health care provider. Where once we looked to crystal balls, now we summon the power of sand – the silicon sand that enables microchips to process artificial intelligence and business intelligence to intercept and translate words that lead to actions.

To quote Frank Outlaw, Watch your thoughts, they become words; watch your words, they become actions. It is those actions we attempt to predict by managing and monitoring your words.

FEATURES

We leverage speech analytics to monitor and score the words that each patient speaks to us. We estimate in 2018 that we will hear, transcribe and score over 1.5 billion words spoken by patients. This provides us a wealth of data from which to leverage and assess which patients are most likely to escalate.

We begin this process by listening. Our speech analytics tools automatically listen to and create a transcription of each call. This includes all inbound and outbound calls. As the calls are recorded in stereo, with the patient recorded in one channel and the patient service representative recorded in a separate channel, we can easily apply rules to either the patient or representative or to both. We can also listen for specific words that trigger identification of patients who are agitated or not have a wonderful patient experience.

Following is a list of a sample of triggers that our speech analytics tools listen for and score:

  1. Call Emotion
  2. Agitation
  3. Dissatisfaction
  4. Escalation
  5. Legal Action Mentions
  6. Profanity
  7. Risk & Abusive Language

We can listen for these triggers to each spoken word and phrase included in calls placed or received by our customer call centers. In addition to calls, we can apply these rules to any written communication to or from a patient.

As we’ve compared the various speech analytics rules to over 100,000 patient satisfaction surveys, we have identified a series of triggers that correlate with reduced patient satisfaction. If any of the above speech analytics rules are triggered, our data scientists have been able to identify a significant reduction in patient satisfaction. Of all of the criteria identified to negatively impact patient satisfaction, the triggering of these speech analytics triggers has the most significant impact on patient satisfaction.

We can further delineate which calls trigger one or multiple of these triggers. As a patient triggers additional speech analytics items, we are able to further identify those patients as most likely to escalate to hospital or health system leadership. We can also listen for specific words of escalation, which imply that a patient is directly planning to call hospital leadership.

For the first time, we can isolate those patients who are most likely to escalate and provide that list of names to health system leadership. We can provide the early warning system to escalations and assist health care providers in the preparation for those escalations and those patients. We can predict patient behavior.

The introduction of speech analytics marks a substantial leap forward in our ability to monitor and improve the Patient Financial Experience. Previously, a negative call center interaction was difficult for management to find and address. It often required a patient services representative to contact their manager and identify that a call had just gone poorly. Many patient services representatives might be hesitant to do so as they would know their performance on that call would be heavily scrutinized. Or, some negative calls might be discovered through the archaic quality assurance process of randomly sampling and reviewing calls.

Speech analytics provides an opportunity to review all calls, all phrases, and all words spoken. Not only does this automate the identification of calls where a patient has had a negative experience, it also facilitates an opportunity to implement customer service recovery protocols and to predict those patients who are most likely to escalate.

As Maya Angelou stated, “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” We can now provide feedback on how our healthcare provider partners and our team members in the call centers are making patients feel.

FAQS

What aren’t your patients telling you?
In the age of consumerism and increased social media engagement, when consumers (your patients) have a negative experience they are likely communicating that experience to someone. The sad truth is that their communication is rarely to those individuals that can make impactful changes, namely you. By proactively monitoring the financial experience you are delivering you are able to engage in proactive service recovery much the same way your patients are accustomed to in other industries. You will be able to engage with them in ways you never imagined, providing world-class service, driving loyalty and increasing reimbursements.
Why did my CFO hear about this patient complaint before me?
We have all had that experience, the one where we walk into the office on a Monday morning feeling pretty good about where we left the business on Friday afternoon, only to find that message in our inbox from our boss needing to see us ASAP. Even in the best of circumstances, our processes will break and a patient may have a negative experience. With the technologies and data available we should be able to get in front of these experiences before they are escalated to senior management. Your patients often have the best of intentions but they feel helpless in the current environment without pathways to resolution for their negative experiences and it is incumbent upon us to PROACTVIELY monitor the experience we are delivering to avoid the necessity of senior level escalation while at the same time being able to provide better outcomes for your patients. This is the truest definition of a Win/Win!
How do I make impactful operational enhancements to provide a better patient financial experience?
Without visibility and actionable data, this is next to impossible. When looking across the numerous points of patient engagement, both financial and clinical, within your delivery network, having patient scoring methodology is a necessity and not a luxury. It is not enough though to only quantify the experience your patients are having, it is arguably more important, to ensure that the patient financial experience scoring in place empowers you to make identifiable, actionable and trackable operational changes that drive REAL improvements to the experience you are providing. Whether your patients are experiencing an issue with one of your clinical teams, or frustration with payment options available before the service date, your visibility and ability to act are now more critical than ever.

ESSENTIALS

Our ePFXcoach program offers something that every revenue cycle employee would love to have, but few possess: The ability to provide a world-class customer service experience.

For some people, customer service is a true gift. We all know people who give us their undivided attention, who make us feel like we are the only person in the world at that moment. Unfortunately, not everyone has this ability. If only there was a way to train all employees to give this kind of world-class customer service experience, satisfaction would surely soar. It turns out that there are actually proven ways to equip all employees with simple, easy-to- learn techniques that are known satisfiers.

All hospital employees today are being challenged to provide better customer service. Even physicians are now rated on patient satisfaction, with hospital reimbursement tied to this. Its importance is only growing, but it’s a tall order given the realities of health care today. Time-strapped providers are seeing higher numbers of patients with higher acuity, and hospital departments are forced to do more with less. It’s a mismatch between satisfaction growing in importance on the one hand, and dwindling resources on the other hand. And that goes double for revenue cycle employees, who are having some of the most challenging conversations in health care these days. That is where ePFXcoach comes into play.

Our clients often confide that poor training is what’s really behind many patient complaints. It’s not surprising, given the complex conversations revenue cycle employees are having every day. As all of them know, it’s not uncommon for patients to become angry, frustrated or tearful when having tough discussions about finances. Imagine talking about it when you are sick or injured and worried about how you are going to pay your out-of- pocket costs—and to make matters worse, the person having the conversation doesn’t seem to have their facts straight. Any hospital would have a difficult time recovering from that kind of poor financial experience—if it’s even possible. Luckily, there’s another way. Hospitals are leveraging our proven techniques to maintain high levels of satisfaction.

FEATURES

We provide training to give all revenue cycle employees simple tools to allow them to give a world-class financial experience to patients. Once revenue cycle employees experience the training, the effect even goes beyond the hospital doors. Employees tell us that the training has changed not just their professional approach, but their personal relationships as well. That’s how powerful a tool the training is. It can help people become better communicators. Here are some of the things we have learned, based on many thousands of financial discussions with patients:

Active Listening in Financial Discussions is Critical

To the patient who’s being asked for money, it probably doesn’t really matter much if the person they’re speaking with is a brand new entry-level hire with a high school diploma making $10 an hour or a hospital leader making a six-figure income with an MBA. What really matters most is whether the employee is an active listener.

If we try to recall a customer service experience where we were really listened to, it might actually be difficult to come up with one. Imagine a world in which that kind of experience came from revenue cycle employees—not just the single best employee in the department who everyone raves about, but routinely from all employees. People would come to expect it from the hospital, wouldn’t they? And those would be loyal customers of the hospital for life, because active listening is that compelling for people. And training is how we make that happen.

Honestly, it takes a lot of effort to be an active listener, but the effort pays off in some surprising ways. Take a typical escalated call. If the caller is interrupted, challenged, or cut off, it’s a safe bet that person will complain vehemently to a hospital leader or elsewhere. We coach revenue cycle employees to actively listen instead. By allowing the caller to vent, it’s possible to ascertain what exactly he or she is upset over. It might be that a high-interest loan is their biggest concern. If that’s what the employee hears the irate caller saying, that’s important information because now the employee has something to offer the patient-- a zero-interest payment plan might just turn things around. Or it could be something else—every patient is different, of course-- which is where active listening becomes such a powerful tool.

Tailor What You Say - and How You Say It - to the Person You're Communicating With

Anyone who thinks talking about money isn’t personal never tried to collect from a patient. In our ePFXcoach training, we show employees how to tailor their approach to an individual’s personality. If the person seems open to chatting, that’s exactly what the employee does. Engaging conversations can takes the edge off of the serious subject matter for some people. On the other hand, if the person is all business, a direct approach is best. The employee gets right to the point, and simply explains the financial facts in a professional manner. We’ve seen time and again that this personalized approach can avoid friction that leads to escalation. Avoid the frustration that comes from using a “one size fits all” approach to financial conversations.

Avoiding Negative Words Keeps the Conversation Positive

We avoid what we call “zero” words and instead use “hero” words. Time and again, we’ve seen the power of positive words. Instead of stating, “You can’t pay $10 a month because that’s not enough to meet our criteria,” employees state, “What I can do today is set you up on a $25 payment plan with absolutely no interest paid by you.” There are many other examples, but it’s undeniable that some words just trigger a negative reaction. Other words communicate a “can do” attitude that sends a positive message: We are here to help you.

Patients Expect Employees to Know What They're Talking About

A friendly tone of voice won’t be soon forgotten, and it’s impossible to overstate the importance of simply being kind. But no matter how nice the employee is, he or she has got to know the financials. Any caller, regardless of the amount owed, is going to appreciate someone who’s taken the trouble to do their homework before talking about money owed. Whether it’s a $50 copay or tens of thousands in liability, no one should be collecting from a patient if they can’t justify the amount in an easy-to- understand way that’s beyond reproach. Certainty and confidence is something patients will detect immediately. And those patients are more likely to pay their liability.

Practice Makes Even Difficult Conversations Go More Smoothly

Imagine having to attempt to collect money from someone who is cursing at you, crying while on the phone or firing a series of panicked questions at you. That’s all in a day’s work for a revenue cycle employee. Conversations are unpredictable and yet they have common ground. They can be prepared for and practiced, just as any challenging conversation. And the more you practice, the better you get. S cripting that sounds robotic satisfies no one. The art is to interject one’s personality into the scripting for a natural conversation. That is the beauty of role playing, which allows employees to practice responses. If they hit a wrong note, some coaching and suggestions helps them to gain confidence. They can succeed with conversations in the “real world” where it really counts.

Satisfied patients who are being asked for money? It might seem like the impossible. But we can and do equip revenue cycle employees to give world-class service. And once they really get it—we see that employees put the skills to use eagerly. It’s as though they always wanted to give excellent service—nobody likes to get complaints-- but just didn’t have the tools to do it. The training has a domino effect on the employee and the revenue cycle, giving both some new life. The employee is now enthusiastic about coming to work. The customers have no reason to escalate. The revenue cycle is a source not of complaints, but of satisfaction.

FAQs

I have people engaging with my patients, why are they not having better experiences?
The pre-access and registration teams are arguably two of the most critical drivers to your success when it comes to providing a best in class patient experience and driving the recoveries that are so very critical to your mission. In many cases we place an unfair burden on these teams with the sheer volume of tasks we expect them to complete, the high turnover amongst these roles and necessity of their managers to deliver productivity vs. team enablement. Training and your ability to leverage it, reproduce it consistently, and have it be the foundation these teams are built upon is critical to your success.
We have initiatives and tools in place to collect at the time of service, why am I not driving better results?
It is often referred to as ‘just one more thing’… our registrars can collect patient responsibility, it’s just one more thing for them to do… our registrars can discuss payment options in the context of this patient’s HDHD, it’s just one more thing and they are having the conversations anyway, right? The reality is, in many cases, your registrars are struggling to simply complete the registration tasks so that they can get the patient to their clinician and the additional tasks, while they may be completed occasionally, are often the first items to be neglected. This will cause an inconsistent delivery of your patient experience and gaps in processes that may have significant implications downstream relative to denials, timely filing and many other unintended consequences. Consistent training that provides for accountability to not only process, but outcomes, is a tool you must leverage to deliver the experience and results you need.
Why are my patients having a different experience at Registration vs. my Business Office?
While we all wear badges with the same name and logo, our access to training, the reporting structure of the individual teams and the goals and metrics they are measured against in many cases are wildly different. Ensuring a consistent voice to your patient can feel like an impossibility in these challenging circumstances. Providing these diverse teams access to consistent and time-tested training will be one of the most impactful tools you can lever in your quest to provide best in class patient experience and increased recoveries.

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