Patient experience has never received as much attention in health care as it does today. In a world where individuals are empowered with information – from review sites to social media networks – and a vast number of choices – primary care, urgent care, telemedicine, virtual visits, even house calls – it's no wonder we pay close attention and invest big bucks to improve patient experience.
While the "front end" tends to be more scrutinized (from check-in to waiting room times to actual care delivery), often overlooked are "back end" functions – especially billing.
"Empathy" isn't the first word that usually comes to mind when pursuing improvements in bill collections, but it should be. Helping patients with their bills isn't just about getting paid. It's about cementing customer relationships for the long term. Losing one visit of revenue is bad; losing a valued customer is worse. A "hard approach" toward bill collection should be a last resort. Instead of hounding patients about an outstanding balance, we carefully talk and listen to customers, with a goal of improving understanding of any given bill; and in doing so, improving collections and improving customer relationships.
At Austin Regional Clinic, an empathetic approach is being combined with two other important themes: one-call resolution and enabling technology. Together, they are improving patient experience – and our collections.
Bills Get Misplaced
In the shuffle of life, a bill can get lost. This is often what we find in our research into reducing bad debt, a term used for a past due payment exceeding six months. Bad debts can become very expensive to collect, especially through third-party collection agencies.
Our research shows patients usually intend to pay their bills. The reasons are understandable and sometimes our fault — they didn't know there was an outstanding bill; they never got an answer to their questions about a bill; or they didn't know they had bill-pay options such as payment plans.
ARC tried a third-party vendor, but ultimately brought collections back in house again after developing a clear improvement strategy and a consensus to resource the function to be successful – and it has been. No one knows and understands our patients the way we do, so no one is better qualified to work with them through the billing process.
Avoiding Customer Ping Pong
It seems like everyone has had this experience: calling a company with a question, then being connected (and put on hold) with two or three other people before getting your question answered … partially, many minutes or maybe hours later. This is customer ping pong – and it doesn't feel good on either side.
We learned the hard way that increased patient billing complaints also lead to high employee turnover within our billing operations. Implementing a one-call resolution approach eliminates "phone tree fatigue," leading to happier patients and a happier, more fulfilled customer service staff.
It is a lot of work. At ARC, we engaged in six months of customer service and technical training to ensure billing team members could answer nearly all questions that come up or have the right resources at their fingertips. We continue to provide training to maintain the culture of service.
This in-depth training led to an important, additional benefit: less billing team turnover. Retaining these employees makes extra training an investment, not a sunk cost, and saves ARC money.
Enabling Self-Service
Like the saying goes, you can't go cheap and win. Implementing more online options for invoices and payments is a costly endeavor, but it's paying off for ARC. In just six months, we went from zero to 24 percent of payments coming in online.
Patients see it as a convenience; less staff time is needed; and the online platform can be used simultaneously for communications and marketing while giving patients greater control of their ARC accounts.
Attention to back-end patient experience pays off – not only by successfully resolving bill collections, but in empathetically addressing patient concerns and keeping them as paying customers over the long term.
Ted Matthews, MBA, CPA, CGMA, is Austin Regional Clinic's Chief Financial Officer.