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Making Costs Transparent for Patients: Q&A With HBI’s Noelle Wysocki

By: Enrique Bakemeyer
Date: March 18, 2020
Category: Revenue Cycle
Filed under: customer service, patient-friendly collections, Point of Service Collections, Price Transparency, Revenue Cycle Training
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In the wake of new price transparency regulations, patients have questions about the cost of their care, especially what they owe out of pocket. Since high-deductible health plans are very common, many patients likely owe more than they had in the past. Healthcare organizations must be able to help patients understand the cost of their care, and make customer service a top priority when collecting those out-of-pocket balances.

Having financial discussions with patients about what they owe can be very uncomfortable for front-line revenue cycle staff. Recognizing this, HBI’s Learning team offers a workshop on Point-of-Service Collections Best Practices (click here to learn more). Noelle Wysocki, CRCL, HBI’s learning product lead, shares some of her insights on keys to point-of-service collections success below.

What are healthcare organizations missing when it comes to point-of-service collections training?

Wysocki: Asking for payment can be uncomfortable for revenue cycle team members. We talk about it in terms of an “I can‘t” issue, or an “I won‘t” issue. Is it a matter of aptitude or attitude? “I can’t” is aptitude: I don’t know how do it, I don’t know what buttons to click, I don’t know how to ask somebody for money. I’m happy to do it, but I don’t know how.

Then there’s “I won’t,” which we encounter more often. “I won’t” is attitude: I don’t want to, I don’t feel comfortable doing it, I think it’s rude, I don’t want to bother this person, I’m worried the patient will get angry with me.

The “I won’t” issue is where healthcare organizations are less successful at training. They excel at covering the “I can’t,” but often they don’t invest the same amount of time to address the “I won’t.”

How can you get through to team members who have an “I won’t” mindset?

Wysocki: The first layer of that is training them on the roles of the revenue cycle. What does point-service-collections mean to the rest of the revenue cycle? How does it help your internal team? The second layer would be, how is it going to benefit the patient themselves? What kind of service does this provide? One answer is, it helps the patient with their budget. It helps them understand what they‘re getting involved in.

When your car breaks down, it’s an unexpected expense. The mechanic is going to give you a quote, and then you can either pay for that right now, or you may need to figure out how to make that work. The mechanic has no problem telling you how much that‘s going to cost.

With healthcare, it’s a little more emotional, and the patient may be hurting or stressed. But we still need to be able to give them that financial information so they can prepare, so they can make arrangements that are best for their families and their circumstances.

If we withhold information, we’re doing them a disservice. We’re not giving them access to charitable programs, or discounts, or applications for grants. Being transparent with patients about what they owe is a real benefit to them.

What are some other tactics you use to make front-line staff more comfortable?

Wysocki: Where we go bigger is to say, how much did your organization write off last year? One of our clients wrote off $10 million in 2018. What could the organization have done with $10 million? They could have opened more clinics, they could have hired more people, they could have launched new service lines. A few people we trained said, “maybe they could have given us a raise.” Maybe they could have!  A healthcare organization can‘t keep serving the community in the absolute best way possible if it can’t pay its bills.

The fact of the matter is, these days patients are responsible for a large portion of healthcare dollars. We have to be comfortable explaining to them what that means, and asking them how we can help them make that payment today. Our workshop is about making point-of-service collections more than just a task on a job description. It’s connecting it to the human impact of collections.

Having an empathic and empowering conversation about point-of-service collections starts with mindset. We train them to think, “It is my responsibility to teach patients about what’s to come. This is how I can care for the patient. Doctors and nurses do their thing for the patient’s physical health. It‘s my responsibility to help the patient care for their financial health.”

In addition to mindset, what technical skills are necessary for effective point-of-service collections? 

Wysocki: We go over terminology. Most people can’t explain what a deductible is, what coinsurance is, why this copay is different from that copay, or why their premiums don’t cover a healthcare bill. If staff don‘t understand those terms themselves, they are not going to be able to have successful financial conversations with the patient in front of them who are relying on them for information.

We spend a lot of time going over the glossary of terms and the cost-sharing pyramid. We help them feel comfortable with when a deductible kicks in, what coinsurance is, what an allowable is. Not every patient is going to ask them what all these things mean, but the one that does, they need to be ready and confident in how to explain it.

In addition to Point-of-Service Collections Best Practices, HBI offers workshops on engaging remote workforces, managed care account management, trainer development, and more. To find out more about HBI Learning workshops, fill out the form below!

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