[Video] – The Manager’s Minute Episode #8 – How to Dismiss a Patient
In Episode #8, Mary Pat details how to handle one of the practice manager’s most sensitive duties: dismissing delinquent or problem patients.
Posts Tagged customer service
Guest Author Donald “Tex” Bryant: Good Communications Equals Good Outcomes
According to Charles Duhigg in his newly released book, The Power of Habit, Rhode Island Hospital was one of the nation’s leading medical institutions. It was the teaching hospital for Brown University and the only Level I trauma center in southeastern New England. Rhode Island Hospital also had a reputation as “a place riven by internal tensions”. In one surgery for instance, a neurosurgeon was preparing an emergency surgery for an elderly gentleman with a critical subdural hematoma. Just before the surgery a surgical nurse noticed that the medical chart and other paper work did not indicate the location of the hematoma. The nurse cautioned that the surgeon should wait until the needed paper work was seen. The surgeon yelled at her that he had seen the cranial scan and said he knew where to operate. He didn’t. He opened the skull on the wrong side. Although he corrected his mistake quickly, the patient died soon thereafter. Such errors are not foreign to most hospitals but the number of errors at this hospital due to poor communication, especially between nurses and physicians who overpowered them with their authority, eventually created a culture of high tension and anxiety.
Posted in: Day-to-Day Operations, General, Leadership
Leave a Comment (1) →Guest Consultant Brendan Betancourt: Do You Hire Based on the Candidate’s Ability to Smile?
If you are like most people, you probably don’t even notice if a candidate smiles spontaneously. During interviews, most of us are so consumed with the candidate’s skills, and finding out if they can do the job, that we often over look important aspects that in many cases may be more important.
The funny thing is that you can teach people most any skill, but you can’t teach them to smile. And for people in the service industry, smiling is probably the most important skill of all.
While researching a talk, I came across this little story that Tom Peters told in one of his presentations.
I once said to a Starbucks regional manager, “I’m stunned that almost all of your store people, from the U.S. to Saudi Arabia, always sport a smile. What’s your secret?”
She smiled as she answered: “We hire people who smile!”
And to keep them smiling?
“We promote the ones who smile the most.”
Could it be that simple?
Guest Author and Consultant Bob Cooper: Respecting All Team Contributions
The NCAA basketball final game is now set. Kentucky and Kansas will meet on Monday evening to determine who will be the national champion. What is so fascinating is to watch how different players contribute in key situations that make the difference in the ultimate outcome.
Mary Pat discusses “Coding for the Rest of Us” for Nuesoft’s Video Podcast Series
After Mary Pat’s “Coding for the Rest of Us” post this July, she sat down with Lyndsey Coates from Nuesoft as part of their monthly Healthcare IT Podcast to discuss more about how even a basic understanding of coding among patient contacting and administrative staff can improve patient experiences as well as the group’s bottom line. Check it out!
Teaching Staff to Be Welcoming to Patients
Many years ago when I started in healthcare I noticed a certain attitude of the staff toward the patients. It was as if the physicians, nurses and other staff were bestowing an honor upon the patients when they provided them with care.
It was not until later that I realized that exactly the opposite was true. It is we who are privileged to earn the trust and confidence of the patients who allow us to serve them.
Someone once explained it to me this way:
Imagine you are the host and you have invited several guests to your home. You’ve cleaned the house and prepared everything so that your guests will be comfortable. You’ve turned on all the lights and placed a welcome mat outside the front door.
Your guests have arrived at the front door and have rung the doorbell.
You open the door, see your guests…and slam the door in their faces!
This essentially is what you do when you open your doors for business, then treat your customers poorly. You have invited them to do business with you, then have not been welcoming and appreciative when they accept your invitation.
If you have staff who don’t understand how important it is to form relationships with your patients beginning with a warm welcome, help them to envision each patient as arriving with an engraved invitation in their hand.
Image by LexnGer via Flickr
Posted in: Amazing Customer Service
Leave a Comment (1) →21 Common Sense Rules for Medical Offices
Image by George Eastman House via Flickr
There seem to be a lot of people searching for rules for medical offices. I’ve never heard of such rules, but since people are looking for them, I thought I’d write some.
- Medical offices are professional workplaces and staff need to dress, speak, and purport themselves professionally.
- Patients are customers and customer service should be paramount. Give all patients the utmost respect and practice compassion, compassion, compassion.
- If it didn’t get documented (on paper or electronically), it wasn’t done. If it didn’t get documented, you can’t charge for it.
- HIPAA. First of all, please spell it correctly. One P, two As. Secondly, know what it means and make it so!
- Never enter an exam room without knocking.
- Confirm patient identity (name, date of birth, etc.) before giving injections, taking specimens or performing a procedure.
Image via Wikipedia
- Remove very sick or very angry patients from the front desk immediately. Take the sick ones to exam rooms and take the angry ones to the manager’s office.
- Do not use medical jargon with patients. If they don’t know what you’re talking about, they might be too intimidated to ask.
- Wash your hands. Often. No matter what you do in the practice.
- The office should be CLEAN, fresh and up-to-date. No dying plants, no magazines more than 9 months old, no dust bunnies behind the doors, no stained seating or carpets.
- Train staff to apologize, and to apologize sincerely.
- Complaints from patients and staff need to be addressed in 2 weeks or less.
- Medical equipment is to be maintained and tested annually for safety and performance.
- Once a medical record is finalized, the only changes to a paper record are single line strike-throughs with corrected information and initials, or addendums. There are no changes to electronic records, only addendums.
- Patients don’t understand insurance. Be the expert.
- Shred confidential practice paperwork and patient-identified information on-site.
- Keep medications (including sample medications) in locked cabinets and use a good inventory system to log the use and replacement of stock.
- Strive to meet patients at their communication level. Use graphics, translated materials and interpretive services when needed.
- Don’t expect patients to be on time for their appointments when the provider isn’t.
- Don’t make copies from copies.
- Give everyone the benefit of the doubt. There’s always more to the story. Okay, this is really a rule for life in general, but it works in medical offices too.
Leave a comment and tell me what rule you would add.
For more medical office rules, read “Ten Golden Rules for Your Medical Office Staff.”
50 Customer Service Ideas to Treat Your Patients to Friendly, Easy and Unexpected Service
Here’s a companion piece to my recent list “50 Ways to Attract New Patients to Your Practice.” Once a patient makes an appointment to see your provider, be sure to keep them coming back by wowing them with your customer service.
FRIENDLY
- Introduce yourself to patients. “Hi, I’m Jane and I am Dr. Smith’s assistant and I’ll be working with you today.”
- Wear a visible and readable name tag with your first name in large letters.
- Smile and speak to all patients, family members, and vendors in the practice. If anyone has a question mark on their face or is hesitating, be sure and ask “May I help you?”
- Always smile while speaking on the phone and always introduce yourself. “Good morning, Dr. Smith’s Practice, this is Jane. How may I help you?”
- Providers should always shake hands with patients and others in the exam room. That first touch is so important!
- New patients should receive a special welcome and should receive special attention, remembering that the patient doesn’t know how the practice works.
- Have a patient information brochure that describes your practice’s services, providers, and policies on medication refills, after-hours services, filing insurance, filling out forms, and making payments.
- Have multiple ways for patients to complete their registration information – forms mailed to them, online completion, completion in the practice at a computer kiosk, completion at the practice with personal help, or pre-registration by phone.
- Ask patients how they would like you to communicate with them about lab/test results – telephone (home, work or cell), email, mail, phone retrieval and let them know (in writing if possible) when they should call if they haven’t heard from you.
- Place tablets and pens in the waiting area so patients can write down questions for their provider while they are waiting.
- Have computers in the waiting area for patients to use. Have Wifi for patients to use their own computers while waiting. Have instructions available for using the Internet to look up medical information and provide a written list of medical websites that your providers recommend. Place this information on your website.
- Prior to touching a patient in the exam room, assistants and providers should wash or sanitize their hands and be sure the patient can see them doing it. Additionally, it’s good to say to the patient “Let me wash/sanitize my hands before I examine you.” so the patient knows you are practicing good infection control.
- Provide staff with patient questions and preferred answers so everyone can answer most questions and no one tells patients “That’s our policy.”
- Have a water fountain with cups in the reception area.
- If you have a television in the reception area, make sure patients can change the channel or the volume.
- Invite patients to become a friend of the practice on Facebook and communicate regularly with your patients keeping them up-to-date on practice news, health news and local events.
- Pretend that every patient is a mystery shopper (and they are!) and treat them like a VIP.
- Give patients a way to reach a real person on the phone, and a way to go through the automated attendant. Remember that not every patient wants or needs the same thing.
- Have an annual open house or patient appreciation day and do blood pressure checks or home safety checklists. Serve healthy snacks and visit with your patients.
- Call 2 days before the patient’s appointment and remind them of the date and time of the appointment. Ask them to press “1” if they plan to keep the appointment and “2” if they would like to cancel the appointment.
- When the patient is checking out, ask “Were all your questions answered today?”
- If you give out wrapped candies, make sure to supply sugar-free candies as well as regular.
EASY
- Have multiple ways for patients to complete their registration information – forms mailed to them, online completion, completion in the practice at a computer kiosk, completion at the practice with personal help, or pre-registration by phone.
- If your parking lot is shared with other businesses, make sure there are parking spaces marked specifically for your patients.
- Use wayfinding systems to help patients navigate around your practice. Many patients will not read signs, but will identify symbols or pictures if you explain the system. Use themes for providers or services to help patients find their way when coming out of the bathroom or lab. Carpet or tile designs and art pieces can also be used creatively to direct patients in and out.
- If you have a choice, front-load your practice space with patient rooms and leave the furthest rooms for non-patient activities such as offices and staff rooms.
- Give patients their medication list and problem list on a wallet-sized card.
- Bring services to the patient exam room instead of having your patients move around the practice.
- Offer numerous payment options including financial assistance, Medicaid enrollment, medical loans, checking account drafts through debit cards and credit card drafts.
- Offer a “chat with the insurance lady” feature on your secure portal.
- Have new patient pre-appointments for patients to meet with staff to take baseline vitals, log medications and prep chart prior to their first visit.
- Have maps available for patients for any place you might be referring them to, whether in town or out of town.
- Give patients a sheet to take with them that lists medication changes, future appointments, referrals and has a place for them to write down questions between appointments.
- Give patients a customized sheet that shows the name of their medication, what the medication looks like and how to take the medication.
- Send patients emails or letters and post on your website any information relating to hot topics in the news – vaccines, radiation exposure, etc.
- Make your website a one-stop destination for practice information, health information, practice forms and secure messaging with the practice.
UNEXPECTED
- If a patient has a particularly unhappy experience in your practice: a long wait, a mixed-up appointment, give them a gift card with a sincere apology.
- Hand-write an apology to a patient who has had an bad experience with a staff member.
- Validate parking for patients if they have to pay to park to come to your practice.
- Ask patients to rate your service – have forms in the exam rooms and in the waiting room and in new patient packets and on your website.
- If your practice is near a shopping or eating area, give patients a pager to buzz or ring when it is time to see the provider.
- Use your EMR or voice recognition to complete the patient’s medical record and print them a copy of it to take with them when they leave the exam room.
- Have a blanket warmer to give patients who are sick, or have come in on a gurney a warm blanket.
- Go through the daily obituaries to know when patients have passed and send condolences to the family.
- Have an option on your phone system to speak to the manager and take complaints personally. Answer all complaints and call any patients back who leave messages, and any patients that employees tell you had a problem at the practice.
- Call new patients the day after their appointment to see if they had any questions after their first visit.
- Call particularly sick patients the day after an appointment to see if they are improving. (Thanks to Kristen Baird.)
- Give patients who call a benchmark for when they will hear back from you (2 hours for same-day visits, 6 hours for questions, etc.) and exceed your own benchmarks.
- Have a mystery shopper come to your practice and tell you what you don’t know about your practice.
- Send your patients a birthday card.
What do you do in your practice that is Friendly, Easy for patients or Unexpected?
Posted in: Amazing Customer Service
Leave a Comment (3) →Guest Author: Denise Price Thomas Talks About Being a Mystery Patient and the View from “The Other Side of the Desk”
Welcome Denise Price Thomas, practice administrator (32 years) and consultant. Throughout her career, Denise has been passionate about creating positive experiences for patients and customers. She enjoys teaching customer service and effective communication. She strives to inspire others by using heart-warming stories and humor gleaned from her management experience in her informational, inspirational and motivational presentations. In addition, “Gladys Friday”, (aka Denise), completes the package of “Health, Hope & Humor” by telling entertaining stories about funny moments in health care settings.
I received a call from a practice administrator who said, “When I am observing the front desk staff, I find them to be helpful and attentive to our patients, however when the patients are visiting with the physician, he receives multiple complaints per day. I cannot be with them at all times.” This is so true as is in many practices. The staff is on their best behavior when the administrator, manager or physician is around.
After meeting with the administrator and physicians, it was decided that they were in need of a practice evaluation, to see how things look “from the other side of the desk.”
I was to be there at 10:00 am. The administrator and physicians were aware but they had elected to keep the surprise to themselves.
I arrived to find the sliding window CLOSED. Although it was a clear glass (thinking the person on the other side could actually SEE through it) I just knew it would open…..it didn’t. In fact, nothing happened. The receptionist was “busy” writing and her head was down. As I stood there waiting “patiently” (as she thought I WAS a patient), I looked around at all of the real patients, looking through magazines – angrily flipping pages. I could tell immediately that they had been greeted in the same manner. There were loud sighs, eyes rolling as they looked at their watch; people were not happy.
After giving it a few minutes, I decided to tap on the CLOSED window. Still without looking up, she said, “I’ll be with you in a moment!” After waiting another minute or so…..I decided to put on my brave suit and go for it. I slid the CLOSED window open and said, “May I see your administrator please?” (still trying not to give it away). She said, (again without looking up – I still have NOT seen her eyes – nor has she seen mine) “M’AM, I SAID I would be with you in a minute!” I politely said, “thank you.”
BINGO! I had located the trouble, when suddenly there appeared before me….the administrator. I was so happy to see her. She said, “Denise, come on back.” She introduced me to the clinical staff and we made our way to the front desk. She said to the “greeter” at the front desk, “this is Denise, she will be performing a practice evaluation to see how we may improve our services.” The “greeter” said, “It is SO NICE to meet you.” No, it really wasn’t. She decided at that point that she needed to be nice to me when she should have been NICER to her PATIENTS, the reason she was there.
Realizing that she wasn’t really a “people person” to say the least, it was decided that she work in another area in the practice, where she was happier and the person from medical records was much happier working with the patients.
End result, happier patients, happier physicians, happier staff.
Moral of this story: You can have the most wonderful physicians but if you have a sub-standard staff, patients will not be happy.
Things to look for in a front desk applicant:
Fortune teller ”“ able to know when someone has changed insurance companies, divorced, remarried, deleted insurance, moved, etc.
Air traffic controller ”“ able to smoothly divert patient traffic in an attempt to keep them from running into others and finding out their “time of arrival” is the same as others. Able to handle maximum doses of STRESS!
Medi-copter pilot ”“ able to hover over an emergency, assess and remove the patient in distress and deliver them to the safest place AWAY from the lobby – seeking clinical assistance ”“ while remaining calm
Multi-lingual ”“ able to understand multiple languages and be able to effectively communicate
Coach ”“ able to motivate the team, support the team, protect the team while being part of the team’s proactive plan, not the team’s problem
“One Ringy Dingy” – Switchboard Operator”“ able to pleasantly answer each phone call addressing each one as it is the only call
Multi-tasker ”“ able to effectively & efficiently perform multiple tasks while wearing a smile and a positive attitude ”“ with each patient
Juggler ”“ able to maintain balance while keeping eyes on the patient
Circus trainer ”“ able to be the master of MANY ceremonies
Reservation Concierge ”“ scheduling and rescheduling while exhibiting exceptional customer service skills, GLAD that the person has contacted their practice for “reservations” (an appointment)
Infection Control Officer ”“ ensures cleanliness and minimizes germs
Minimalist ”“ able to work without the clutter igloo around them
Walmart Greeter ”“ happy to see everyone that walks through the door
Helpful characteristics to look for when interviewing a medical front desk applicant:
Unflappable
Patient
Exhibits kindness
Compassionate
Positive attitude
Exhibit good eye contact
Nice soothing voice
Multi-tasker
Non-complainer
Willingness to help others before themselves
Desire to be cross-trained
Does not have the words, “It’s not my job” in their vocabulary
Most healthcare workers that have BEEN a patient or have been with their family member through sickness”¦..make great healthcare employees. They KNOW how it feels to be on “The Other Side Of The Desk”
Denise Price Thomas
Note: Denise’s partner in DPT Consulting &Training is Gladys Friday, pictured here. If you are interested in contacting Denise or Gladys about their services, they can be contacted through their website here or by phone at 704-747-8699 or via email to denisepricethomas@gmail.com.
Readers & Colleagues Comment on “101 Ideas for Increasing Revenue and Decreasing Expenses”
I invited readers of MMP, colleagues on LinkedIn, and Tweeps (friends on Twitter) to comment on my post “101 ideas for Increasing Revenue and Decreasing Expenses.” I’ve listed their ideas below and hope you’ll chime in on the comments with even more ideas! Thanks to everyone for contributing.
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Partner at B2B CFO® – Experienced CFO for Rent. Fast, Effective, Affordable.
Consider adding a part-time CFO to the mix. Many medical offices have very weak financial capability or understanding. Assistance can range from better financial reports, capital expenditure analysis, budgeting and exit plans.
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Eastern Region Sales Manager – Billing Tree
1) Build a relationship with the patient before he/she leaves the practice.
2) Make sure they know you are expecting payment on the portion they owe, and when you are expecting that payment.
3) Let them know what your process is for collecting, and when they will go to an outside agency.
4) Enable a web site to take payments 24 hours a day.
5) Set up an IVR system to take phone payments after hours.
6) Communicate your available payment acceptance methods in writing, on the phone and every time you speak with your patients.
7) Send the invoice or statement when you intend to send it.
8) Re-inforce the payment acceptance methods on the first and any subsequent invoices.
9) Adopt a plan for following up with any patients that don’t pay after 10 days.
10) Get email addresses from all of your patients and their permission to contact them in that manner.
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Sr. Product/Process Trainer and EDI Implementation Consultant
One suggestion would be to integrate the revenue cycle mangement function with your clearinghouse {for electronic billing} with integrated solutions like Coding database and Updates, Industry Broadcast, Performance and Audit reports for Claim Edits, Transmission and Rejects. Also, better training resources for billing staff actively into the practice management system.
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Consultant at Pacific Women’s Medical Group
I would add effective cash management (even if interest rates are so low).
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Medical and Business Consultant at Transworld Systems
Utilize a Flat Fee Collections Agency for Non-responsive Patient Pay concerns.
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Principal Consultant – Culbert Healthcare Solutions
– Do you collect co-payments on the way in rather than on the way out?
– Does your PM/Scheduling system show the patient co-payment and outstanding patient balance in the appointment screen? If not, then can you download a listing for your front desk staff?
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DPT Healthcare Consulting & Training
I’d like to add “acknowledge the patient with eye contact” and offer “polished customer service” and they will WANT to return = return on your $ $
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Managing Partner, Dynamic Grape Companies
One other thought… don’t be afraid to try new technology. For example, one of my clients has developed a kiosk that allows patients to take their own weight and bp and electronically feeds the data into their EMR. The whole set up costs about $3500 and can save a ton of staff time. Tele-health in general should also be considered.
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VP at Operations
If you select a reasonably priced EMR and you implement enhancements then you more than save on staff cost. Keep in mind that my practice rolled out the EMR five years ago, so we have had time to get it right. Here are some of the savings/revenue opportunities:1. We utilize our electronic technology to send text messages and emails to our patients to remind them of their appointments. This function alone saves my practice one FTE. Not only do we save with staff time we improve patient satisfaction, as our Blackberry users loves the email or text that they can directly add to their calendars. The revenue enhancement to this function, we decrease no shows and lag time in our physician’s schedules.
2. The robust reporting within the EMR allows the organization to assemble important quality measures that we use in contract negotiations. Without the EMR this would be a labor intensive task.
3. We are able to push a secure message to our patients regarding their pathology results saving staff time on the telephone and increasing patient satisfaction by eliminating a visit just to obtain a normal result.
4. No more chasing charts for a phone message. My call center takes ALL clinical messages. This is attached to the patient’s electronic chart and routed to either a nurse to respond or a physician. This process greatly reduces staff time, decreases the time it takes to respond to the patient’s issue and provides a legal record of the telephone call which is often missed in a paper environment.
5. We receive a discount on our mal-practice insurance because in an electronic environment it is guarantee that your notes are legible.
6. The formulary function built into most EMR’s provides the physician will a real time snapshot if a prescription that he/she is about to write is covered by the patient’s health plan and provides alternatives if available.
I have just highlighted only a couple examples of the administrative benefits. There are many more. It is tough to imagine going back to a paper chart.
I have done the math and we could cover our current EMR with the incentives offered through the government initiative.
I will comment that physicians need to be trained on how to use the EMR. You can lose site of the patient and focus the entire visit on the computer versus the patient, however, we teach our physicians that the patient first and then chart completion. We conduct patient satisfaction surveys and I rarely receive a complaint regarding the physician’s time at the computer. I do however, receive praises from patients regarding the ePrescribe as it decreases their wait times when the arrive at the pharmacy, the prescription is ready.
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Okay Readers, it’s your turn – what’s your secret weapon for increasing revenue or decreasing expenses?
Mary Pat
