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 President
The White Stone Group
Michelle Fox, MBA, MHA, CHAM
Director, Revenue Operations, Patient Access, Health First
Joe Imbruglio
Manager, 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 Group
First & Last Impressions | Perception
of Care| Impact of Communication

Revenue Cycle Impact
Pre-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% Satisfied
with 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 Requests
Scheduling Requests
Critical Results
Transfers
Referrals
Faxed Orders
Verbal Orders
Precertifications
Concurrent Review
Medical Necessity
Precertification
Claim Status
VOB/VOE
Appeals
Denials
Negotiations
Contract Negotiations
Notification of Discharge
Notification of Admission
Worker’s Compensation
Discharge Placement
Employee Reviews
HR/Hiring Records
Patient Transfers
Bed Availability
Scheduling
Physician Orders
Quality Assurance
Medication Orders
Admission Requests
Patient Status Changes
Notifications/Workflow
Out-of-Pocket Estimates
Scheduling/Reminders
Customer Service Calls
Financial Counseling
Risk Management
Pre-Registration
Registration
Billing Inquiries
Patient Follow-up
Discharge Instructions
Identity Theft Protection
Medical Record Requests
Medicare IM/HINN Notice
PROVIDER PATIENT
PHYSICIANPAYER

Physicians Payers
Patients Providers

Capabilities
Retrieve
Fax
Electronic
Voice
Share
Evaluate

Trace Voice & QA Tools
Overview

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 First
Touch 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 Measures
Question 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 First
Scripting | 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 Fox
Director, Revenue Operations, Patient Access, Health First
michelle.fox@health-first.org
Joe Imbruglio
Manager, Patient Access, Health First
joe.imbruglio@health-first.org
Blair Wright
Executive VP, The White Stone Group, Inc.
blair.wright@twsg.com

Thank you!

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

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