Jena McCoy-Lovern tackles some challenges to establishing and maintaining a positive relationship with patients
Patient satisfaction is a priority at the office of endodontist Matthew T. Ankrum, DDS. However, a few months ago we began to realize that the trend toward higher patient financial responsibilities could present a challenge to establishing and maintaining the warm, personal relationship between patients and staff that has been a hallmark of the practice.
…the trend toward
higher patient financial responsibilities
could present a challenge to establishing
and maintaining the warm, personal
relationship between patients and staff that
has been a hallmark of the practice.
Historically, a revenue strategy hasn’t been considered a priority for patient-provider relationships. Patient eligibility and benefits verification were handled by employees responsible for contacting insurance companies. These calls or emails were initiated as soon as the patient’s procedure was scheduled. Typically, a predetermination of benefits was not requested because the endodontist tries to schedule procedures as soon as possible to relieve any patient pain. Due to the short amount of time available to verify benefits and the difficulty reaching insurance companies, patients seldom were asked to pay their portion of the bill at the time of service.
In addition to spending an average of 60% of the day on the telephone to verify benefits, we also tracked claim payments. The practice’s revenue system did have a feature that showed when the claim was received and when it was processed, but there were many times a check was received before the system listed it as a processed claim. Because the validity of the information was suspect, we often had to make telephone calls to follow up on claims.
Payment timeframes varied from 2 to 3 weeks from the best payers to 4 to 5 weeks for others. The delay in receipt of insurance payments delayed generation of bills to patients, with some patients not receiving final bills until almost 2 months after their procedures.
To address the strain that increased financial responsibility places on the patient-provider relationship, the practice implemented an integrated patient experience and revenue strategy. The change in process not only improved the staff’s ability to engage the patient in financial conversations prior to a procedure, but also led to unexpected benefits in every aspect of the office’s operations – including more timely insurance payments, improved patient payment rates, and enhanced staff productivity.
Patient-centric service important
As a small practice with one practitioner, one office manager who has a clinical background, and two dental assistants, the idea of implementing a revenue management system might never have been an initiative if not for a conversation with a colleague in another practice. When the colleague described access to real-time information online and the ability to collect patient responsibility at the time of service, the benefits became apparent.
Once the decision was made to develop a new revenue management strategy, several essential goals were established for the new approach:
- Focus on patient experience
Because an endodontist often sees a patient only once, it is critical to make a good first impression and establish a positive relationship in a single encounter. Our practice’s reputation relies on word-of-mouth recommendations throughout the community and positive feedback to referring dental providers. The new revenue strategy had to improve the patient’s experience in addition to any financial benefits the practice realized.
- Improve staff efficiency
Technology had to enhance staff efficiency, providing such attributes as reliable, real-time benefits, and eligibility verification, claims filing and tracking, and patient billing. The new system needed to minimize the amount of time one staff person spent on the telephone with insurance companies, which could be better used in interactions with patients and support of clinical staff members.
- Enhance payer and patient collections
Waiting up to 3 months or more to receive the final payment from patients not only negatively affected practice cash flow, but also required staff time for follow-up. The practice needed a system that outlined the patient’s financial responsibility before or at the time of service to enable meaningful conversations about payment.
It was only after leveraging technology to support revenue
management that we realized how much time and effort was spent on activities that
can be automated.
New strategy enhances reimbursement
The new process, implemented in March 2013, focuses first on the patient by initiating financial conversations when patients are scheduled for their procedures. Easy access to benefits information enables a discussion that clearly outlines the cost of a procedure and the amount of the bill that is the patient’s responsibility. The ability to share detailed information about how the patient’s portion of the bill is determined provides patients with an opportunity to ask questions so they understand the process. This improves the patient’s comfort with the accuracy of the estimate and gives the patient time to ask about payment plans or other approaches to payment that fit their financial situation. Success of the new strategy is attributed to:
- Real-time information
Estimates are more accurate because the information is real-time, so patients can see exactly what is applied to the deductible and how the co-pay is determined. Even when all of the payment isn’t collected at the time of service, these conversations eliminate the shock of a large, unexpected bill, and patients have time to make payment arrangements.
- Reliable claims tracking
Changing the technology used to file and track claims has also significantly increased speed of insurance payments. One claim’s payment was received in 5 days after the procedure. While 5 days is uncommon, all claims are now paid faster than before – with accounts receivable days decreasing from 2 to 3 weeks to 1 week – and we no longer need to constantly call to follow up on claims processing. Clear reports that show the status of claims provide a quick look at what requires follow-up action, so time is not spent reviewing individual claims’ status.
- Correction of claims before submission
Another key to quicker claims processing is our ability to automatically check claims for incorrect patient identification data or other anomalies that might result in a rejection or delay in payment. The ability to verify information with the patient and correct inaccuracies before the claim is submitted has decreased denials significantly.
- Shorter timeframe for patient billing
An unexpected benefit of faster claim payments is quicker payment by patients. They know upfront that they are responsible for a portion of the bill, and because their final bills are generated days following their procedure rather than many weeks, they are paying more quickly. Most payments are received after the first statement, and 95% of accounts are paid after two statements.
Technology enhances patient-focused service
Not only did the new process improve efficiency for the staff member handling insurance, but overall efficiency in the office has improved. Having that person available to interact with patients in the office enabled the addition of an extra patient to each day’s schedule – so seven patients are now seen each day. The additional slot means the practice can respond more quickly to a patient’s acute need for treatment.
As patients become increasingly more responsible for dental bills, it’s even more important for endodontic practices to assure patients have a positive experience throughout their visit. Taking a close look beyond the clinical approach to front- and back-office revenue processes is integral to meeting this new patient-provider dynamic.
The most important lesson learned through this process is that management of benefits verification and claims payment should not be hard. It was only after leveraging technology to support revenue management that we realized how much time and effort was spent on activities that can be automated.
One of the most rewarding benefits of the new strategy, however, is improved patient service. Although the practice has always been known as one that recognizes a patient’s name, we are now able to spend more time educating patients about clinical and financial issues. Our ability to answer their financial questions has greatly improved due to greater access to reliable, real-time information.
