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Patient Experience Archives - Pinnacle III

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

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.

 

Implementing a Patient Texting Program at Your ASC

Implementing a Patient Texting Program at Your ASC

By ASC Development, ASC Management No Comments

Over the last two decades, texting has grown into one of the world’s most effective and accessible communication methods. However, there are still some professional service sectors where more traditional communication (e.g. phone, mail) is more common. It may be surprising to know that some health care entities are beginning to offer patient texting programs, sending important reminders to patients. For those in the ASC industry, this is an exciting opportunity to demonstrate to patients you care about modernizing and updating their delivery of care as well as your interactions with them. Is your ASC poised to take advantage of this chance to show you provide the best and most convenient options?

Here are a few interesting statistics about smartphone and text messaging use:

  • Ninety-five percent of Americans own a cellphone of some kind.[1]
  • Texting is the most widely used smartphone feature, with 97% of Americans using it at least once a day.[2]
  • Ninety percent of all text messages are read within three minutes of their delivery.[3]
  • It takes the average person 90 seconds to respond to a text message.[4]
  • Texting is for everyone. Ninety-four percent of smartphone users 70 and older use text messaging on a weekly basis.[5]

Statistics like these helped inspire our ASC to implement a patient texting program in November 2017. Before launching the program, many of our patients were receptive to the idea of receiving text messages from our ASC. As part of our program, patients are asked if they want to receive text messages from us when providing their medical history through our online portal. An average of about 80 percent of our patients opt in.

We hoped that by leveraging the power of texting, we could improve the experience of our patients and staff.

Developing the Texting Program

Our texting program is managed through an online patient portal vendor. Working with this company, we customized a series of automatic text messages which are sent to patients preoperatively and on the day of surgery. We carefully crafted our messaging and determined the most appropriate time for message transmissions. This “automated clinical pathway” provides instructions and prompts patients to complete important steps in their procedure preparation. Personal health information is never transmitted to maintain HIPAA compliance.

Here is a summary of our text messages:

Two days before surgery, morning. Our first message asks patients to confirm the date and time of their procedure.

If patients are unable to make their appointment, the message advises patients how to reschedule.

If patients confirm their appointment, they receive another automated message reminding them to review their physician’s preoperative instructions.

Two days before surgery, evening. This message provides instructions about what patients need to bring with them on their day of surgery. We also remind them to bring a method of payment and ensure they arrange for transportation.

Day after surgery, morning. Our final automated message thanks patients for allowing our ASC to provide care during their surgery. It also expresses our hope that they are recovering well. If there is a problem with their recovery, the text message instructs patients to call the ASC and ask to speak to a nurse.

Note: Patients can opt out of receiving texts from the ASC at any time. For patients who choose to do so, and those who do not opt in to receiving texts when providing their medical history, we communicate via phone and/or email.

Texting Program Benefits

Due to the widespread use of text messaging, patient texting programs are primed for success. During the first three months of this program at our ASC (November 2017-January 2018), all patients who opted to receive text messages responded to the automated messages. Most confirmed their appointment through the text message; the remaining called the ASC.

Here are some of the tangible improvements your ASC may experience after implementing an ASC patient texting program:

  • Decrease in number and duration of nurse calls to patients (savings of about 10 minutes per call)
  • Decrease in staff hours per case
  • Increase in staff efficiency and satisfaction
  • Increase in patient compliance with physician and ASC instructions
  • Decrease in patient no-shows and cancellations
  • Increase in patients paying for care prior to day of surgery (an unexpected benefit)

Growing the Patient Texting Program

After experiencing the success of a patient texting program, ASCs may consider exploring ways to expand the use of texting. One idea is to incorporate front office staff into the patient texting program. For example, after verifying benefits, front office staff may choose to send an automated text message to patients. The message could indicate patient financial responsibility after verified insurance deductions, and prompt the patient to arrange for payment.

Another solution is sending a one-time text message to patients. This would come in handy if, for example, there was a significant snow storm or catastrophic event and the ASC needed to close. The ASC could send a text to all affected patients on the surgical schedule.

One other area to grow a patient texting program is sending text updates to family members in the waiting area. These would provide an update on the status of loved ones in surgery.

The Importance of a Patient Texting Program

An ASC patient texting program demonstrates to patients your ASC cares about consistently modernizing and updating your health care services with a focus on what works best for patients. This is a powerful message to send to your customers in the ASC industry. Studies show 64 percent of consumers prefer texting versus a phone call for customer service needs and 77 percent of consumers are likely to have a positive perception of companies that use text messaging.[6] In the ever-changing health care market, texting is expected to become an even more valuable communication tool going forward. You can bookmark this as a 2018 ASC industry trend.


Michaela Halcomb, Director of Operations


[1] http://www.pewinternet.org/fact-sheet/mobile/

[2] http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/

[3] http://connectmogul.com/2013/03/texting-statistics/

[4] https://www.ctia.org/

[5] https://www.tatango.com/blog/94-of-seniors-are-sending-text-messages-weekly/

[6] https://www.openmarket.com/blog/infographic-consumers-favor-sms-messaging-yet-online-retailers-are-missing-the-massive-opportunity-to-engage/