Thursday, August 13, 2015

Patient-Friendly Loans to Improve Collections

We’ve long advocated that medical practices abandon their traditional “Pay-me-or-else” approaches to debt collection and switch to a “How-can-I-help-you?” posture. Healthcare collections bring special challenges that are not quite like any other billing process. Consider these unique characteristics:
  • Unplanned debt. Even the most conscientious and frugal folks don’t really expect to incur medical debt. Patients feel unlucky and resentful from the outset.
  • Third-party payers. Patients don’t usually understand how insurance works—and new, higher copayment requirements mean uncharted territory for even the savviest patients.
  • Healthcare as a fundamental right. Popular opinion today views healthcare as a right to be provided regardless of ability to pay. Whether you agree or not, the question remains: Who pays for care to the entitled?
  • Physician image. The media have relentlessly recast physicians as a bunch of rich, greedy, heartless vultures preying on humanity’s misery. Even people who don’t buy that characterization can hardly help thinking, “I think they have enough without my money, too.
Factors like these make patient collections an uphill battle from the outset. And practices that have tried to become more “business-like” in their billing and collections have often seen their slightly improved collections come at the cost of their public professional image. At a time when the predominantly third-party-payer system necessitates increased patient volume—resulting in reduced time with each patient—a hard-nosed collection policy drives a wedge ever deeper between the doctor and his or her patients.

Hospitals have traditionally suffered worse collection ratios than physicians—for many reasons. An impersonal approach to billing and collecting (sometimes outsourced) has hurt more than it has helped. Those institutions exploring “interest-free” financing are starting to report some real successes.

In a sense, hospitals have found a way to do what many practices used to do before profit margin tolerances became critically thin. Most medical practices used to let patients pay whatever they could, without interest or penalty. Hospitals never could afford to do that because people on such an “honor system” have a hard time paying a faceless institution. Paying your doctor—especially one you continue to see on occasion—carries a different dynamic.

Larger practices may be able to arrange with a local bank for an interest-free loan program for their patients. (As a matter of fact, the first time we heard of this, we were working with a very creative administrator at a 35-doctor multi-specialty practice back in 1988! He made a deal with a local bank for affordable interest and limited recourse.)

Get your accountant to help you crunch the numbers and project costs and benefits for offering interest-free financing for patients with large balances. (Remember, though, it’s not interest free for you!)

If you enjoy reading the blog entries in "Solving Problems in the Medical Practice" you may want to check out all the great products at Greenbranch Publishing.

Friday, August 7, 2015

Smart Strategies in Dealing with Difficult Patients

Dealing with difficult patients
Dealing with difficult patients.
Prevention still trumps any remedy you can devise. If you want to minimize patient complaints, take the time (and we're talking about a lot of time!) to formulate, document, and implement thorough policies and procedures covering every aspect of your practice. Then communicate these policies thoroughly and effectively—it would be hard to “over-communicate.”

Billing issues and lengthy wait times top the list of complaint topics that ignite patient tempers at most medical offices. But other typical triggers include: Staff members giving hasty/incomplete/confusing answers to their billing questions, office personnel addressing patients too familiarly (first names, for example); and providers discounting/dismissing patients’ online research.Very often, these triggers mask underlying concerns or worries that cause the real anxiety. Handling unhappy patients requires the daunting task of uncovering the real issues.

You can avoid a certain amount of confrontation by making sure you have clearly communicated your office policies from the outset. Clear financial policies and patient-friendly rescheduling procedures go a long way in preventing those volatile moments.

Dealing with an angry patient absolutely requires unwavering professionalism on your part. Train staffers to maintain their best demeanor in the face of confrontation. Use scripting and role-playing to prepare employees for these tough moments of truth. Make confrontation-training an ongoing program—staff members need constant reminders.

Elevate empathy to become a core value for your office. Failing to empathize results in the patient feeling like his or her complaint has been brushed off—marginalized. Teach staffers to see things from patients’ points of view. Ask them, “How would you feel in this situation?” Show workers how to use tactics like “reframing,” wherein the employee helps the disgruntled patient see a situation from a very different angle, thus redefining it.

Teach communication strategies like asking the patient a couple of obvious questions that elicit a “yes” answer. That actually helps set a positive tone for the rest of the conversation. Insist that staffers follow up all the way to a successful conclusion if even remotely possible.

Create patient handbooks, brochures, Web pages, and posters that inform and remind everyone about how you intend to serve each person who comes to your practice. Monitor staff members closely to make sure everyone is following the rules.

Of course, even the best-constructed boat might bump an iceberg once in a while. That’s why you teach “emergency” procedures to the whole crew. Service disasters will happen—and your staff members must know how to execute “disaster-recovery” procedures as well.

Six tips are:
  1. Letting the angry patient know you understand 
  2. Soliciting what the angry patient wants from you 
  3. Offering the help you can provide (and clearly describing what you can’t do) 
  4. Setting limits on what patient behaviors you will tolerate 
  5. Assuming the patient is probably doing the best he or she can do 
  6. Believing in yourself—that you’re also doing the best you can do 
Believing in yourself (and the patient) can energize you and help you stay “above the fray.” It helps keep you from taking the patient’s anger personally and increases your personal patience. Finally, be circumspect about introducing humor into a heated situation. Avoid making light of the situation directly—you don’t want the patient to think you don’t take him or her seriously!

Finally, give your frontline staffers the authority (within reasonable limits) to resolve situations—and a direct path to your door if the solution requires even more authority. Maintain detailed patient-complaint logs. Use the logs as quality improvement tools.

If you enjoy reading the blog entries in "Solving Problems in the Medical Practice" you may want to check out all the great products at Greenbranch Publishing.