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patient education Archives - Pinnacle III

Sep 28
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When a Screening Colonoscopy Becomes Diagnostic: Educating Patients on Financial Responsibility

When a Screening Colonoscopy Becomes Diagnostic: Educating Patients on Financial Responsibility

By ASC Management, Uncategorized No Comments

A patient comes into your ASC and undergoes a screening colonoscopy. Polyps are found during the procedure and are removed. Considering the circumstances, this sounds like good news. The screening served its purpose. You detected and removed cancer precursor lesions, hopefully helping to prevent the disease.

There’s just one problem: The patient is angry. Not about the successful removal of the polyps, but about how a change in type of procedure also changed the patient’s financial responsibility. A scheduled screening colonoscopy has become a diagnostic colonoscopy. Rather than being a preventative service provided at no cost to the patient after their insurance has processed the claim, the patient now owes a payment – possibly one considered quite significant.

Guidance for Screening Colonoscopy Education

By taking a proactive approach to colonoscopy education, your ASC can help reduce its number of upset patients. You may even improve their satisfaction in the process. Here are some recommendations on how to help patients understand their potential financial responsibilities before undergoing a colonoscopy.

Develop Documentation

Alleviate some of the confusion about colonoscopies by providing patients with documentation explaining possible outcomes of their screening colonoscopy. Share background on preventative services, noting limitations on this provision. Explain how the definition of a preventative service is adjusted due to changing (and strict) insurance guidelines. Elaborate on how this may affect patients scheduled for a screening colonoscopy and their financial responsibility. Define the categories of colonoscopies: screening/preventative, diagnostic/therapeutic, and surveillance/high-risk.

This background information will hopefully help patients gain a better understanding of colonoscopies. Then summarize what can happen when patients receive a screening colonoscopy referral. Describe how categorization can change based on information captured during the scheduling and pre-procedure processes. Consider addressing some frequently asked questions, such as whether physicians can change a diagnosis so a procedure can qualify as screening and why insurance companies may seem to indicate that your ASC can alter a CPT or diagnosis code.

Share Benefits Information

Along with this documentation, provide patients with information about their colonoscopy benefits. Give your benefits coordinator a form to fill out when they review coverage information online and/or contact patients’ insurance carriers. This form would include details on patients’ covered benefits concerning screening and diagnostic colonoscopies. It would also state patients’ financial responsibilities (or potential responsibilities), broken down by co-pay and deductible.

You may want to include details about payment plans your ASC offers on this form. This can help patients start planning how they will pay for their care if the colonoscopy categorization changes. Include this form with the background documentation.

Speak Directly With Patients

While these documents should better prepare patients for their colonoscopy and possible financial outcomes, calls to patients are also worthwhile. Use this opportunity to review the information in the documentation and form. Ensure individuals at your ASC who speak with patients can explain the difference between screening and diagnostic colonoscopies. Staff should receive training to help them effectively communicate with patients and accurately answer questions.

Quick Tips for Dealing With Upset Patients

Despite your best educational efforts, you may still receive phone calls from upset patients following their colonoscopy. Consider following these steps to help address their concerns:

  • Let them vent. If patients sound animated, give them time to share their thoughts and feelings. Avoid interrupting and try to respond only when asked a question. Giving patients this opportunity to vent can help them calm down and become more focused on the discussion to follow.
  • Remain polite. Throughout your conversation, strive to remain polite, listen carefully and remain calm. If patients believe you are becoming frustrated, not listening closely, or failing to take their concerns seriously, they are likely to become angry.
  • Review case history. Help patients feel like you take their concerns seriously by discussing the details of their situation. Pull up their chart and bill. Talk through the procedure: what was scheduled and found, and how that affected information submitted to their insurance carrier. Verify that your ASC properly coded and billed the procedure.
  • Explain insurance rules. After discussing the case history, patients may still question what they owe. Describe health insurance rules and how they dictate changes in colonoscopy categorization. Provide education on diagnosis codes and your ASC’s requirements to code based on the procedures performed, not scheduled. Discuss the claims submission process and how that triggers the health insurance reimbursement process. Note: If patients spoke with their insurance before you, they may have been told that had you coded the procedure as a screening colonoscopy, it would have been covered. Be prepared to explain the potential fraud implications of improper coding and billing.

Going through these steps can provide comfort to patients and help them better appreciate your ASC’s responsibilities. Once you address any outstanding questions, move to the discussion about how patients will cover what they owe. Be cognizant that patients may be in a delicate state as they come to accept their financial responsibility. Help relieve some stress by informing them of payment options that can spread their financial responsibility over time. While patients may express displeasure with what they’re hearing, patience and compassion can move the situation toward a positive resolution.

Catherine Sayers, Director of Operations

May 15
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Effective Health Care Marketing Goes Beyond Driving Business

Effective Health Care Marketing Goes Beyond Driving Business

By ASC Management No Comments

Health care regulations and policies are constantly changing, which makes health care marketing dynamic and challenging. Most marketing focuses heavily on targeting the right audience and delivering a tailored message to that audience. If the message is successfully transmitted, it drives demand for the health care service and consequently increases business and revenue. However, more nuanced effort is required to effectively market your surgery center and drive revenue growth.

Although patients may arrive at the specialist’s or ASC’s doorsteps through effective advertisements or physician referrals, there is no guarantee patients will stay to receive treatment for the same reasons.

For effective long-term business growth and retention, patients need to view your ASC as a reliable, trustworthy, and competent place to receive care. This is not fulfilled through marketing alone; it requires commitment from your entire organization.

Building Trust with Patients

Health care fits into the service industry category, where trust is translated into currency. Patients seeking care are already experiencing some vulnerability and stress related to their health. From the moment your patients walk through the door, and even before this point, they are assessing how your ASC responds to their needs and the quality of service they can expect to receive. In other words, can they expect your ASC to live up to the expectations set forth by your marketing campaign?

Long gone are the days when companies were able to unilaterally control their marketing message. Nowadays, patients are doing the marketing for providers, whether the providers agree or not. Technology has provided a platform for consumers to express their feelings and experiences online about the businesses with which they interact.

One study by the Local Consumer Review has indicated positive online reviews make 73% of consumers trust a local business more.[1] It is crucial to understand how patient experience and brand reputation go hand-in-hand in an increasingly digital world.

Focusing on Patient Experience

Strong marketing strategies focus on optimizing patient engagement to enhance positive brand reputation. That engagement starts with the initial marketing, but it solidifies through the patient’s experience at the ASC.

Here are some ways to improve patient experience:

  1. Set expectations through patient education.

Offer patient education through different platforms to establish patients’ expectations for their care. Patients get frustrated when there is a lack of information about their procedure, which sets the stage for unintended miscommunication. By being proactive in creating simple, relevant guides, you will contribute to your patients’ overall perception and experience.

  1. Invest in customer service education for your staff.

Your staff is the “face” of your organization. Patients tend to care more about how they are treated than the facility’s appearance. Educate your staff on how to engage with patients in positive ways, and how to ask patients to provide feedback about their experience. You may also consider giving staff a simple flyer or cut sheet to hand to patients which outlines how to leave an online review for your ASC. Evidence shows that 70% of consumers will leave a review for your business when asked.[1]

  1. Invest time in communicating with your customers.

Technology has changed consumers’ expectations about how businesses communicate with them. Be aware of what patients are saying about your organization and be proactive in responding to what they are relaying. Let your patients know you are open to feedback, whether it’s good or bad.

Also, it is important to understand where to communicate with your patients. Although a recent study shows Yelp & Facebook are local consumers’ most trusted review sites,[1] other platforms are being used for consumer reviews. One of the services Pinnacle III provides to its facilities is managing each ASC’s online reputation. We foresee demand for patient interaction expanding, not decreasing.

  1. Have a service recovery plan.

This applies to both patients and referring physicians. As a physician, you value your relationship with your patient. As a surgeon, you value the trust other physicians place in you when they refer their patients to you. What if a mishap occurs that could potentially tarnish those sacred relationships?

It is wise to prepare your staff members to handle an unhappy patient or referring physician partner. By focusing on customer loyalty versus attempting to gain new ones, you may realize more positive benefits in the long run. Frederick Reichheld, author of the Loyalty Effect, stated that a five-percentage point increase in customer retention increases profits by more than 25 percent.[2]

Better Business at Your ASC

Targeting potential consumers with tailored marketing messages can help lead patients to your health care door, but their arrival is only half the battle. Comprehensive and results-driven health care marketing also incorporates the patient experience when they seek treatment at your physician office and/or ASC. Stay in-touch with the ever-changing health care market to make sure you are providing the best possible service for your patients’ needs. Seek to build trust with patients and you will be rewarded for your efforts. Recognizing and prioritizing each patient’s overall experience ensures health care marketing results in long-lasting, loyal relationships.

Alice Beech, Physician Liaison

[1] https://www.brightlocal.com/learn/local-consumer-review-survey/

[2] Reichheld, Frederick F., and Thomas Teal. The loyalty effect: the hidden force behind growth, profits, and lasting value. Harvard Business School Press, 2008.