Communicating Effectively: Strategies to Ensure the Quality of Communication with Patients

NAHAM 40th Annual Educational Conference & Exposition

Communicating Effectively: Strategies to Ensure the Quality of Communication with

Patients

Blair Wright, Executive Vice PresidentThe White Stone Group

Michelle Fox, MBA, MHA, CHAMDirector, Revenue Operations, Patient Access, Health First

Joe ImbruglioManager, Patient Access, Health First


Learning Objectives

• Review opportunities to impact patient experience in pre-service areas such as scheduling, registration, financial counseling and upfront collections.

• Consider methods to monitor and manage communication with patients for clear and accurate messaging.

• Evaluate impact of a scoring tool used to conduct quality assurance and staff training in communication with patients.


Communication: Are You Getting Through?

Blair Wright, The White Stone GroupFirst & Last Impressions | Perception of Care| Impact of Communication


Revenue Cycle ImpactPre-service

communications set the tone for the entire

encounter

Post-service communication may be

last touch point a patient has with the organization

These interactions are about health and money; two of the most emotional subjects we deal with as humans.


Perception of Care

3 of 4 patients rate hospital quality based on perception of care

rather than objective measures.

Source: Professional Research Consultants, National Consumer Perception Study, 2006.


Perception & Clinical Satisfaction

93% Satisfiedwith Clinical

Satisfied with Billing Experience

63% Satisfied with Clinical

Source: “Study Shows Link between Patient Satisfaction with Billing Experience and Clinical Satisfaction,” Executive Insight, ©2011.

Unsatisfied with Billing Experience


The strongest predictor of overall HCAHPS scores is how patients rate provider

communication skills.

HCAHPS & Communication

Source: Bavis and Fulton, Press Ganey Whitepaper, 2008.

Medical Record RequestsScheduling Requests

Critical ResultsTransfersReferrals

Faxed OrdersVerbal Orders

Precertifications

Concurrent ReviewMedical NecessityPrecertificationClaim StatusVOB/VOEAppealsDenialsNegotiationsContract NegotiationsNotification of DischargeNotification of Admission

Worker’s CompensationDischarge PlacementEmployee ReviewsHR/Hiring RecordsPatient TransfersBed AvailabilitySchedulingPhysician OrdersQuality AssuranceMedication OrdersAdmission RequestsPatient Status ChangesNotifications/Workflow

Out-of-Pocket EstimatesScheduling/RemindersCustomer Service Calls

Financial CounselingRisk Management

Pre-RegistrationRegistration

Billing InquiriesPatient Follow-up

Discharge InstructionsIdentity Theft Protection

Medical Record RequestsMedicare IM/HINN Notice

PROVIDER PATIENT

PHYSICIANPAYER

Medical Record RequestsScheduling Requests

Critical ResultsTransfersReferrals

Faxed OrdersVerbal Orders

Precertifications

Concurrent ReviewMedical NecessityPrecertificationClaim StatusVOB/VOEAppealsDenialsNegotiationsContract NegotiationsNotification of DischargeNotification of Admission

Worker’s CompensationDischarge PlacementEmployee ReviewsHR/Hiring RecordsPatient TransfersBed AvailabilitySchedulingPhysician OrdersQuality AssuranceMedication OrdersAdmission RequestsPatient Status ChangesNotifications/Workflow

Out-of-Pocket EstimatesScheduling/RemindersCustomer Service Calls

Financial CounselingRisk Management

Pre-RegistrationRegistration

Billing InquiriesPatient Follow-up

Discharge InstructionsIdentity Theft Protection

Medical Record RequestsMedicare IM/HINN Notice

PROVIDER PATIENT

PHYSICIANPAYER




Physicians Payers

Patients Providers


Physicians Payers

Patients Providers


CapabilitiesRetrieve

Fax

Electronic

Voice

Share

Evaluate


Trace Voice & QA ToolsOverview


Voice On-Demand™ • User-initiated recording of

inbound/outbound calls and voicemails

• Hardware connection to user PC• Ability to index and add

comments


Voice Auto-Record™ • Auto-recording of all calls

without user initiation• No hardware required for

user PCs• Ability to index and add

comments


Voice Anywhere™ • Recording of calls via any phone

(cell, Wi-Fi or off-site)• Dedicated number to initiate

auto recording• Ability to retrieve to index,

add comments


Voice Face-to-Face™ • On-demand recording of live,

in-person conversations• Desktop microphone attached

to user PC• Ability to index and

add comments


Tracker™ • Retrieve• Share• Evaluate


Health First: “Accessing” the Patient Experience

Michelle Fox, Health FirstTouch Points | Expectations|

Satisfaction Measures


Health First, Inc.

• Located in Brevard County

• 4 not-for-profit hospitals• 920 acute-care beds• Other services:– 4 outpatient diagnostic centers– 300+ Health First employed physicians– Health First Health Plans


Setting the Tone

• Obtain correct information• Schedule and register patient appropriately• Ensure services are covered and reimbursed

Patient experience begins in

Patient Access

• Staff scripted with opening and closing scripts

• Specialized training in customer service

First phone call or

face-to-face sets the tone


Physician scripts Consents and authorizations

Insurance benefits verification

Prior authorization Notification of admission

Patient out-of-pocket estimate

Financial Counseling/Medicaid

Eligibility

Identify payer sources

Patient Access Touch Points


Patient Expectations

• Information regarding benefits

• Prior auth and/or precert completed prior to service

• Knowledge of costs and out-of-pocket expectations

• Services are covered by insurance company


Satisfaction MeasuresQuestion Surveyor

Ease of Scheduling an appointment? Press Ganey

Ease of Registration process? Press Ganey

Waiting time in Registration? Press Ganey

Staff was friendly and courteous? Press Ganey

How would you rate the hospital? HCAHPS

Would you recommend the hospital? HCAHPS


#1 Issue – Communication

Scripting• timeliness, accuracy of

communication• keeping patients and family

members informed

Setting Expectations• time estimates• patient responsibility• discharge info


Drilling Down: Active Listening

• Level 1 – Not hearing, not listening• Level 2 – Hearing, not listening• Level 3 – Hearing and listening for:• Content – the stated needs• Intent/Emotion – the unstated

needs

3 Levels of

Listening:


What makes an effective listener?

Don’t interrupt, don’t jump to conclusions

Ask the right questions

Take notes

Concentrate, prepare in advance

Use interjections or acknowledgements

Check your attitude


Care & Empathy

95% of the time….WHAT you say and HOW you say it determines the outcome of the interaction

Take ownership – you are there for them

Assure – you will handle their situation

Paraphrase – acknowledge what they have said so they know you are listening


Strategies to Ensure Effective Communication

Joe Imbruglio, Health FirstScripting | Recording | Quality Review


Scripting

Impact of Key Words at Key Times


Health First Scheduling QA Scorecard


Clear, Accurate Communication

Call recording

Face-to-face communication

QA reviews

Quality measures, competency reviews

Training


Voice Recording at Health First

Authorizations, certifications, referrals

Physician calls

Verbal orders from on-call physicians

Scheduling calls

Pricing hotline/estimates

Patient calls on nurse help-line

Calls in Emergency Department

Customer service calls

In-person encounters


Monitoring

Monitor quality indicators (wait times, talk times, abandonment rates)

A percentage of each scheduler’s calls are reviewed on a monthly basis

Quality/accuracy goals set for each employee and reviewed each month


Communication Quality Manager

Tool used to perform consistent, objective QA of communication;

quickly pinpoint issues & training needs

• Score cards and reports: Track and trend quality scores by team, agent or focus area

• Random recording selector: Generate list of randomly-selected recordings to eliminate reviewer bias in scoring

• Bookmarking: Bookmark recordings and return to a particular portion during playback

• Review with staff: Share recordings and reports for training and performance improvement


Scorecard


Quality Reports – Trending


Quality Reports – by Team, Question


Introduction of CQM at Health First

• Areas Used– Scheduling– Preregistration– Customer Service

• Areas Measured– Greeting– Process Knowledge– Closing


Health First Plans for CQM

• Process• Rollout• Goals• Timeframe


Getting it Right from the Start

• Recording calls• Monitoring• Scripting• Customer Service Tools (AIDET)• Excellent Communication• Excellent Listening

Ensuring an

excellent patient

experience


Questions?

Michelle FoxDirector, Revenue Operations, Patient Access, Health [email protected]

Joe ImbruglioManager, Patient Access, Health [email protected]

Blair WrightExecutive VP, The White Stone Group, [email protected]


Thank you!

Communicating Effectively: Strategies to Ensure the Quality of Communication with Patients

Healthcare

white stone

user pc ability

exposition

discharge

revenue operations

patient access

exposition

exposition