As a follow up to our recent webinar, How Customer Service Impacts Your Bottom Line, speaker Rochelle Glassman and Kareo have answered the many questions posed by participants. Here are the five most common questions you asked:
Q: How do you deal with patients who cancel appointments regularly?
A: Patients who cancel appointments or surgeries at the last minute can be a huge drain on your practice’s cash flow. Consider implementing a strategy to prevent unexpected holes to minimize the impact of last minute cancellations and no shows on your medical practice.
Set a cancellation policy, and be sure it’s communicated to every patient. Ideally, this takes the form of a document that new patients sign when they first come to the practice. Afterward, make it a point to discuss your policy at the time of booking subsequent appointments or surgery, and when reminder calls or emails go out to patients.
In the cancellation policy, many practices require patients to cancel their appointment at least 24 hours before their scheduled appointment time. For surgeries, the required notice time can be even longer. For those patients who do not comply, consider charging a late cancellation fee.
Collecting cancellation fees can be achieved much more easily than you think when your office is set up to bill for cancellations and accept credit card payments. By creating a cancellation code, you can bill the patient using electronic statements. The day of the cancellation or no-show, process a patient statement and direct the patient to pay online by credit card. Enabling patients to pay online can increase patient payments and speed the turnaround on those payments whether it is for the cancellation fee or for standard co-pays and deductible payments.
Q: What is the best way to address patients who keep calling regarding the same bill even after explaining the bill to the patient?
A: Healthcare reimbursement and payment processes are complicated and often patients do not understand their payment obligations. I would recommend that prior to treating the patient a staff member (financial counselor) explain to the patient their financial obligations (how much they have left to pay prior to meeting their annual deductible, copayment, non-covered services and percentage of the payment the patient is responsible for, etc.). I am a huge advocate of explaining the potential costs upfront rather than having a confused, upset and often angry patient after the fact. Regardless of your efforts to explain the patient’s financial obligations to the patient they still may not understand the payment obligations under their insurance plan, especially elderly patients who will always need you to explain things more than once. However, if this is a common problem, it may be your staff who are not clear with their communication or how they are explaining the patient’s statements. I always recommend asking patients as you talk if they have questions, do they understand what you are covering, etc. If it is a common problem, you might ask someone to be a test case and call in to ask questions to your staff about their statement. Then, have that person tell you if there were areas where things were not explained well or if something caused confusion. That will allow you to address those issues.
Q: I want to provide good customer service but I also want to ensure HIPAA compliance. How do I do this with phone calls? Is there a best practice for leaving messages?
A: As part of your new patient documentation you need to provide patients with options on how they would like the practice to handle any type of communication related to their treatment and test results. It is recommended that a document be prepared allowing the patient to identify approved methods of communication. This may include but not be limited to email communication, leaving messages at certain telephone numbers, who the practice can speak to related to the patients care, would they prefer communication via text or even snail mail. It is important that the patient sign this document on an annual basis as their circumstances may change.
Q: What is the most diplomatic way of curbing employee gossip, especially when the owner is involved?
A: All new employees on their first day of employment before they start their training or job tasks they must review the practice’s employee handbook. All employees must read and sign an acknowledgement form that requires them to follow all the practice’s policies, procedures and behavior requirements. The employee handbook should also detail the disciplinary action the practice may follow should the employee not follow the policies. It is important to be consistent with your performance expectations and follow the guidelines in the handbook. It is a huge challenge to correct an issue when the owner is part of the problem and not the solution. I would recommend that you meet with the owner first and explain the situation and go over the corrective action plan you would like to implement and make sure you have the owners buy-in and support. If not, the entire exercise is futile and you will be undermined by the owner. If the owner does agree to be part of the solution, I would meet with all the staff and go over the practice’s policies and expectations related to professional behavior and what the consequences maybe if the policies are not consistently maintained. If the gossip continues beyond this point, I would deal with the individual employee based on your established policies, which may include disciplinary action up to and including termination.
Q: You said we don’t want patients to be kept waiting and then you said consider double booking. What happens when everyone shows up and you fall behind?
A: I recommend double booking as an option when you have done an analysis on your no shows and identified patterns that indicate predictable gaps in your schedule. For example, if you know that 30% or more of your Medicaid patients don’t show up then you might consider double booking some of those slots. If you find that you double book and everyone shows and you are running behind, apologize to the patient and let them know you are running behind and they will be seen in XX minutes.
If the owner is not willing to change then you have a problem because without the support of the owner it is very difficult if not impossible to implement change.
If your practice identifies a cancellation or no show pattern, for example on average one is every six patients do not show up. I would recommend that the practice double book every sixth patient to maintain cash flow.
If you missed this great webinar, you can view the recorded event or check out the slides.
About the Speaker:
Rochelle Glassman, a passionate advocate for physicians and medical practices who has devoted her career to helping doctors get paid. Rochelle is the President & CEO of United Physician Services, and is a nationally recognized healthcare consultant known for her candor, tenacity, and vision.