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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
NAHAM 40th Annual Educational Conference & Exposition
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.
NAHAM 40th Annual Educational Conference & Exposition
Communication: Are You Getting Through?
Blair Wright, The White Stone GroupFirst & Last Impressions | Perception of Care| Impact of Communication
NAHAM 40th Annual Educational Conference & Exposition
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.
NAHAM 40th Annual Educational Conference & Exposition
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.
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
NAHAM 40th Annual Educational Conference & Exposition
NAHAM 40th Annual Educational Conference & Exposition
Physicians Payers
Patients Providers
NAHAM 40th Annual Educational Conference & Exposition
Physicians Payers
Patients Providers
NAHAM 40th Annual Educational Conference & Exposition
CapabilitiesRetrieve
Fax
Electronic
Voice
Share
Evaluate
NAHAM 40th Annual Educational Conference & Exposition
Trace Voice & QA ToolsOverview
NAHAM 40th Annual Educational Conference & Exposition
Voice On-Demand™ • User-initiated recording of
inbound/outbound calls and voicemails
• Hardware connection to user PC• Ability to index and add
comments
NAHAM 40th Annual Educational Conference & Exposition
Voice Auto-Record™ • Auto-recording of all calls
without user initiation• No hardware required for
user PCs• Ability to index and add
comments
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
Voice Face-to-Face™ • On-demand recording of live,
in-person conversations• Desktop microphone attached
to user PC• Ability to index and
add comments
NAHAM 40th Annual Educational Conference & Exposition
Tracker™ • Retrieve• Share• Evaluate
NAHAM 40th Annual Educational Conference & Exposition
Health First: “Accessing” the Patient Experience
Michelle Fox, Health FirstTouch Points | Expectations|
Satisfaction Measures
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
#1 Issue – Communication
Scripting• timeliness, accuracy of
communication• keeping patients and family
members informed
Setting Expectations• time estimates• patient responsibility• discharge info
NAHAM 40th Annual Educational Conference & Exposition
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:
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
Strategies to Ensure Effective Communication
Joe Imbruglio, Health FirstScripting | Recording | Quality Review
NAHAM 40th Annual Educational Conference & Exposition
Scripting
Impact of Key Words at Key Times
NAHAM 40th Annual Educational Conference & Exposition
Health First Scheduling QA Scorecard
NAHAM 40th Annual Educational Conference & Exposition
Clear, Accurate Communication
Call recording
Face-to-face communication
QA reviews
Quality measures, competency reviews
Training
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
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
NAHAM 40th Annual Educational Conference & Exposition
Scorecard
NAHAM 40th Annual Educational Conference & Exposition
Quality Reports – Trending
NAHAM 40th Annual Educational Conference & Exposition
Quality Reports – by Team, Question
NAHAM 40th Annual Educational Conference & Exposition
Introduction of CQM at Health First
• Areas Used– Scheduling– Preregistration– Customer Service
• Areas Measured– Greeting– Process Knowledge– Closing
NAHAM 40th Annual Educational Conference & Exposition
Health First Plans for CQM
• Process• Rollout• Goals• Timeframe
NAHAM 40th Annual Educational Conference & Exposition
Getting it Right from the Start
• Recording calls• Monitoring• Scripting• Customer Service Tools (AIDET)• Excellent Communication• Excellent Listening
Ensuring an
excellent patient
experience
NAHAM 40th Annual Educational Conference & Exposition
Questions?
Michelle FoxDirector, Revenue Operations, Patient Access, Health Firstmichelle.fox@health-first.org
Joe ImbruglioManager, Patient Access, Health Firstjoe.imbruglio@health-first.org
Blair WrightExecutive VP, The White Stone Group, Inc.blair.wright@twsg.com
NAHAM 40th Annual Educational Conference & Exposition
Thank you!