Stacie Fults, Vice President of Client Development at National Medical Billing Services
Mimi Bender, Senior Manager of Patient Accounts at National Medical Billing Services
In today’s competitive environment, creating the ultimate “patient experience” will truly differentiate your surgery center and is paramount to building a successful and growing ASC. To create this experience, a patient should be treated with care, respect and competence in each and every interaction with your staff, your processes, your technology and your surgeons. This article is going to focus specifically on the front end aspects of the patient experience.
Your front desk staff are the first touchpoint for your patients, be it over the phone or when they walk in the door. Establishing a process that allows patients to move with ease through the registration process, without error, ensures your ASC not only makes a positive first impression, but avoids expensive billing mistakes.
Focus on improving these three areas to realize higher patient satisfaction and lower financial risk:
Thoroughly train front desk staff on all aspects of scheduling, including gathering relevant patient and payer information, providing proper documentation to patients, and verifying insurance. They will also need to contact prospective patients and schedule surgeries for multiple surgeons, filling both near-term and long-term slots. To improve efficiency, leverage a combination of well-developed processes, training, and technology to streamline scheduling, registration, insurance verification, pre-authorization, pre-op, and other front-end processes.
Technology should be utilized to automate these processes for improved accuracy and patient throughput. Self-service registration allows patients to skip the front desk visit altogether. Patients appreciate the convenience while ASCs save on labor costs. And, by authenticating data in real time, these tools allow staff to discuss copayments and deductible amounts on the spot, further strengthening the revenue cycle. Certain software platforms feature self-service check in, transparent wait times and real-time patient status updates for family members.
Insurance verification and pre-authorization should be addressed as early in the process as possible. Not only will you confirm with your patient that the service needed is covered by the insurer, you will also gain early access to billing data such as certificate and group numbers. Consider purchasing a real-time eligibility verification tool that will allow access to the patient’s benefits, the patient’s benefit limitations, and the patient’s out-of-pocket financial responsibility.
Armed with this information, you can discuss the patient’s obligations well in advance of the surgery and provide effective financial counseling.
Almost half of Americans (45.8%) with private health insurance have high-deductible health plans, according to 2018 data from the Centers for Disease Control and Prevention, with deductibles ranging from $2,000 to $6,000. Since 2015 patients have experienced a 29.4% increase in deductibles and out of pocket max costs on average. Even patients with Medicare may be responsible for significant out-of-pocket costs when facing surgery. Considering many Americans have little emergency savings, paying for care is a source of significant financial stress.
Financial counseling ensures that patients understand their responsibility before they arrive for surgery. These counselors help patients understand their health coverage and their out-of-pocket costs. They explain payment options, including payment plans and loans through outside financing organizations, if available at the center. Upfront discussions are critical to make patients aware of and prepared for their financial responsibility.
To ensure counseling goes smoothly, provide patients with an accurate quote that shows how much insurance will pay and how much they will likely owe. Automated tools can help billing staff prepare these quotes. Patients are less likely to experience “sticker shock” and more likely to follow through with procedures if they know what to expect before coming in for a consultation.
If a patient is unable to meet their financial responsibility, and none of the other offered payment alternatives are viable, ask them to sign and agree to a payment plan (promissory note). This process of signing a document and having their signature witnessed and notarized promotes the appearance of a binding contract. If possible, avoid offering payment plans longer than 90 days.
The majority of physician practices and provider facilities (90 percent) agree that collecting from patients before they leave the office is important to their businesses. To this end, 60% of providers contact patients by phone to request payment between 1-14 days prior to surgery; 7% ask for payment on the day of surgery; and 33% do not request it until after surgery. But providers are largely in agreement about the difficulty of collecting after patients leave the center as 85% indicate that it is very difficult to collect from a patient post-surgery. Though most of the healthcare industry recognizes the importance of patient collections and the challenges it can represent, up-front collections remain an underutilized strategy.
If your ASC requires a portion of the patient’s responsibility up front, make sure patients know the multiple ways they can pay, whether ACH, credit card, or Venmo. Also make sure patients have access to and understand how to use your patient portal. As of 2018, 62% of medical bills were paid online and 95% of the consumers polled stated they would pay online if the providers had that option.
Ultimately, ASCs should make sure patients understand their financial obligations as early in the process as possible and collect payment up front prior to the procedure. This helps reduce the odds of uncollected patient debt which, according to our data, can affect your bottom line by up to 30%.
COVID-19 pushed ASCs to not only serve patients differently, but to market differently. While you may want to adjust your patient acquisition messaging, consistent marketing will help your ASC maintain patient volume and increase referrals from both patients and providers.
Reaching out to surgeons’ offices is one “quick win” for improving patient outreach. When patients call to schedule surgeries, make sure scheduling staff have the basics about your ASC readily available by providing them with a basic script that details the pros and cons of surgery at the local hospital versus your ASC.
Building and/or maintaining relationships with referring physicians and partner facilities is another way for ASC marketers to keep referral business flowing. Provide physicians with outcomes data, patient testimonials, and bullet points about your ASC in an easy-to-read format.
Another relatively easy win: evaluate and elevate your digital presence. Many businesses have used their pandemic downtime to re-examine their business goals, their positioning, and their brand. Take the final quarter of the year to get your online presence in shape for 2021. A few pointers include:
Everyone involved in front-end processes shares the goal of maintaining or raising patient satisfaction while ensuring bills get paid on time and in full. By improving front desk efficiency, providing financial counseling early, and by implementing a seamless online experience, you’ll improve revenue cycle and keep patient volume high through 2021 and beyond.
This post was first published October 1, 2020 and was updated October 2, 2020.