The BridgeBlog

By Lorraine Schnelle, CPA

There’s one thing that will never change at your practice or organization. That is patient satisfaction is critical to your success. As ICD-10 preparation activities occur, it’s important to recognize how your transition plans impact the patient’s experience.

Prior to implementing ICD-10, pay special attention to the tests or procedures that are scheduled for October 1, 2013 and after. Both the physician office and scheduling staff need to ensure the correct coding system is used based on the patient’s date of service and the payer. There may be situations where both an ICD-9-CM and ICD-10-CM code will need to be provided. If the appropriate codes are not provided, it could cause multiple delays in scheduling the service and have a negative effect on patient satisfaction.

Wait times may become longer if patient intake must review the order and third party payer to determine which coding system is applicable. Additionally, patient satisfaction may be further affected if intake must contact the physician’s office to clarify the diagnosis code.

As payers receive claims on or after October 1, 2013, there may be delays in the business office and/or as the payer processes the claims. This may result in slowed payment by payer(s) before a patient receives their portion of the medical bill. This may also bear negatively on patient satisfaction.

Even today, prior to implementing ICD-10, if eligibility determination is delayed or not completed prior to a patient receiving service — and ultimately the payer determines it wasn’t a covered benefit — a patient may be understandably upset. This is why it’s important to ensure any eligibility determination processes and procedures, including dual-coding situations, are reviewed and revised to help minimize patient dissatisfaction.

Stay tuned for next week’s post on financial results and ICD-10. Ready, set, go!

By Lorraine Schnelle, CPA

During normal operating cycles, most healthcare organizations do more with less to maximize cash flow — which can be difficult. Now, healthcare faces a major and all-important transition: the implementation of ICD-10 on October 1, 2013.

You may be involved right now in a project related to preparing for ICD-10. Let’s discuss a few reasons to prepare for a change in productivity.

Your organization may upgrade or install one or more new computer software programs; perhaps for the conversion to HIPAA Version 5010 or the transition to an electronic health record (EHR), or another clinical or financial initiative. Some of these upgrades will help prepare for ICD-10; others will help support quality or other programs.

Both the installation effort and system testing requires time and effort. Not only will the information technology (IT) department be involved; but others may be asked to help build and test the system’s functionality. Downtime is also a real possibility and can affect productivity. However, having redundant systems in place can reduce the chances of system downtime during an upgrade or implementation.

Now, we can’t forget that it takes time to learn how to use a new computer system; this process will likely add to the disruption in individual productivity.

What are some issues you can anticipate with a system upgrade implementation? It’s likely that there will be many ICD-10 planning meetings to discuss:

• Computer system issues;
• Processes and procedures;
• Payer issues and contracts;
• Education planning and preparation;
• And other project steps as they relate to converting to ICD-10.

Depending on the amount of time people need for the planning process, individual positions may need to be backfilled with additional staff to maintain day-to-day operations. What can you do to help minimize the impact this will have on productivity?

There may also be a loss in productivity and performance immediately after the transition to ICD-10, as we work with both ICD-9 and ICD-10 codes. Practices and organizations should prepare for processing claims with both ICD-9 and ICD-10 codes, leading to a dual-coding environment.

Adopting and applying these new processes and procedures will take time. How will you help ensure there is time to review and revise your organization’s processes and procedures prior to ICD-10?

Stay tuned for next week’s post on patient satisfaction and ICD-10. Ready, set, go!

By Nancy Friedman, President of the Telephone Doctor

If your job entails taking calls or working with unhappy, irate customers, you’ve got your work cut out for you. Employees who work with this type of situation are especially vulnerable to outbursts from customers who are going through an emotional, stressful time.

Handling this type of customer takes time and training, but it can be accomplished effectively. Here are some of the Telephone Doctor’s best techniques for turning this situation into satisfied customers.

Get Off on The Right Foot

Realize that upset angry customers are not unhappy with you, but with the situation. Don’t take a customer’s hostility personally. You are merely the rod that redirects the violent lightening. You can do a great deal to diffuse the anger before you get to the customer. How? By smiling before you answer that call. You can really “hear” a smile over the phone. It’s very difficult to be rude to someone who is warm and friendly.

Four Steps to Handling the Irate Customer

There are four basic steps to handling an irate customer; we call them our ‘ASAP’ techniques.

A

Acknowledge the person’s feelings and apologize for the inconvenience the customer has encountered. Make an effort to be sincere. In today’s impersonal society, it’s incredibly rare to hear the words, “I’m sorry that happened. Let me get the ball rolling to fix it.” Those are MAGIC words. You’ll probably spend about 80 percent of your time massaging the caller’s feelings and 20 percent actually solving the problem.

S

Sympathize and empathize with the caller. Phrases like “I can understand why you’re upset” can help soothe ruffled feathers. Pretend it’s you calling. Then get busy solving the problem.

A

Accept 100 percent responsibility for the call. OWN IT. This is probably the toughest part. Chances are excellent that you had nothing to do with the problem. However, it’s your job to take the responsibility and help initiate a solution.

P

Prepare to help. Begin by re-introducing yourself – callers don’t usually remember your name. State that you will be able to help. Use the caller’s name, if possible. This helps to diffuse anger. A willing attitude is essential, because if the caller senses insincerity or indifference, it will cause them to stay angry. It’s exasperating to file a complaint with someone who obviously doesn’t care.

Excuses – When to Use Them

NEVER. Never make an excuse to a complaining caller. No one wants to hear “The computer is down” or “I’m the only one here.” That is your problem, not the caller’s problem. When you give an excuse, the caller automatically hears “I’m not going to help you.”

Transferring Calls

Sometimes you’re not able to solve the problem on the spot. Many times you need more information from another department. Perhaps the call needs to be handled by another person. Although these are legitimate courses of action, they usually upset your caller all over again.

If you need more information, TELL the caller. Ask them if they’re able to hold while you obtain it, or would they prefer a call back. “Joe, I need to check with our claims department in order to answer your question. It will take two or three minutes, are you able to hold/wait while I check?” Avoid untrue, frustrating phrases like “Hold on a second.” Nothing takes a second.

If you need to transfer a caller, if you can, let them know the name of the person they’ll be speaking with. It’s also good to explain a reason why you’re bringing in a third party. “Joe, Mrs. Smith in our claims department is the real expert in resolving your type of situation. May I transfer you directly to her?”

For more customer service tips, explore BridgeFront’s Customer Communications online education. Visit our website at www.bridgefront.com, send an email to info@bridgefront.com or call 1-866-447-2211.

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Reprinted with permission of Telephone Doctor Customer Service Training, St. Louis, MO. Nancy Friedman, president, is a featured speaker at association and corporate meetings. She has appeared on OPRAH, The Today Show, CNN, FOX News, Good Morning America, CBS This Morning and many others and has written articles for USA Today and the Wall Street Journal. For more information, log on to www.telephonedoctor.com or call 314-291-1012.

By Nancy Friedman, Telephone Doctor Customer Service Training

It never fails. When management is asked to name one characteristic they’d like to see in an employee, overwhelmingly it’s always OWNERSHIP; to take responsibility.

Certainly, there are other traits they’d like to see, but without fail OWNERSHIP wins. When we talk about “what does ownership mean to you” there are several answers. To make it easy, we’ve taken the word OWNERSHIP and labeled a thought to each letter.

O
Operate as though it’s your business. Take responsibility. There’s no, “It’s not my job” in ownership. There’s only, “I will help you.”

W
Walk in the customer’s shoes. That’s the best way to be sure you understand what’s going on and to help. Pretend it’s you calling in and needing the assistance. What if this happened to you?

N
Never say “NO.” That’s right; even when you’re not able to help or even when the situation is hopeless (and let’s hope it never gets to that). The word NO is offensive, abrupt, unfriendly, overused and tired. There are dozens of positive alternatives we can use to let the customer down gently. To offer a few: “I wish we could” or “Let me double check on that” or “I’m going to take some time and see if we can work this out.” Bottom line, offering NO at the top of your conversation is useless.

E
Empowerment is strength. Having employees empowered to assist by themselves is a strong motivation to do well. The worst they can do is make one mistake; normally, easily corrected and move forward. Empower your employees!

R
Resolution. Sticking with the issue until it is solved. No matter how many phone calls, how many times we re-check something; it’s not over till it’s fixed. Resolved! The mentality needs to be, “Your issues are our issues.”

S
Sending confirmation of the resolution. This is so important. If something gets fixed or resolved and the customer isn’t made aware of it, they can still be upset. The other day we were to have been issued a credit from an airline. We never heard from them. After a third call from my husband to the airline, we were told, “Oh, that credit was on your bill a few months ago.” But, no one bothered to let us know it was coming or that it had been done. Send confirmation or call! Then close the issue.

H
Happiness is key. Happy people love to help. That’s a fact. Your customers love to be helped by happy people. That’s another fact. They can even make the bitter better. (Say that three times fast!) Walk into your job HAPPY.

I
Integrity. This is non-negotiable. Having integrity is a huge part of ownership. Do what is right ALL the time. And remember, having the right to do it doesn’t always ‘make it right.’ Integrity!

P
Personal commitment. Each and every person helping a customer needs to make their own personal commitment that they will take ownership. No more, “It’s not my job.” No more, “I wasn’t here when it happened.” No more, “I don’t know anything about it.”

What does ownership mean to you? Let us know by commenting on this article or send a message on Twitter to @bridgefront.

For more customer service tips, explore BridgeFront’s Customer Communications online education. Visit our website at www.bridgefront.com, send an email to info@bridgefront.com or call 1-866-447-2211.

Reprinted with permission of Telephone Doctor Customer Service Training, St. Louis, MO. Nancy Friedman, president, is a featured speaker at association and corporate meetings. She has appeared on OPRAH, The Today Show, CNN, FOX News, Good Morning America, CBS This Morning and many others and has written articles for USA Today and the Wall Street Journal. For more information, log on to www.telephonedoctor.com or call 314-291-1012.

By Lorraine Schnelle, Co-Founder and EVP of BridgeFront

Remember sitting or standing in a circle and whispering something into the ear of the kid next to you…then watching the faces as your message was passed from person to person. The looks on each face ranged from confusion, surprise, and laughter as you all played the “telephone game.”

This picture popped into my head as I was thinking about a survey question I asked participants in a recent online webinar. The webinar was on educational tools and techniques. The attendees were primarily healthcare finance professionals—many of whom are responsible for managing one or more areas of the revenue cycle.

The survey question was, “What educational activity do you rely on most when delivering staff education?” The top two answers were on the job (OTJ) and one-on-one instruction.

Sounds to me like it could easily turn into the “telephone game” played out in our everyday work world. Don’t get me wrong, the National Training Laboratory found the average retention rate of students participating in “practice by doing” educational activities is 75%. Their study re-enforces the value of OTJ training.

However a word of caution, don’t rely on OTJ or verbal instruction as the main ‘source of truth.’ Because this same study found that only about 5% of what a student hears is retained.

Ensure you have additional educational activities and materials that are and will be used by your staff to support and re-enforce key learning concepts. This material can be in form of online courses, written procedures, video demonstration, work flow diagrams, user manuals, screen shot job aid, etc.

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For more information about BridgeFront’s online education, go to www.bridgefront.com or contact us directly. Call 1-866-447-2211 or send an email to info@bridgefront.com.

By Kent Lane, COO of BridgeFront

Companies with new products generally lack good customer support at the beginning of their product launch. However, when you find a product and company that does break the mold, you should shout about it—and ’shouting’ is what the new company Yard Rents just did.

Yard Rents is a new business in the Portland area. Essentially, they’re an outdoor and indoor equipment rental company that delivers and picks up what you need, when you want it and where you need it. Simply go online, select what you need and then ‘presto’ there they are with a van full of what you ordered.

This company is a perfect merger of internet freedom plus real live customer service. Upon delivery, they helped connect the equipment, instruct me on the usage, test the starting of the engine … and even made sure that I was wearing the right safety devices.

“Holly paradigm shift Batman!” (If you are old enough to remember the TV series Batman and Robin, you enjoyed that quote … if not old enough, sorry.)

These guys have taken the aloof sense of the internet and personalized it to the point where I feel as connected to them as I do any brick and mortar company I do business with. No more will I haunt rental companies, stand in their lines, and tout heavy equipment around … never again. Just point click and open the front door to a smiling, knowledgeable Yard Rents team member.

See them at www.yardrents.com (Portland, Oregon area only for now).

And … while you’re in the learning mood, take a look at your customer service departments. Would someone ’shout’ about them? One look and you may see a cross section of employees that certainly know how to communicate electronically…but can they successfully communicate to your patients and clients?

Give them the training they need to become ambassadors of your organization.  Our ‘Communicating with Customers’ e-learning series will transform any text’er to a successful verbal communicator. Courses are about 20 minutes each, and include real-life experiences and expert tips to handle any situation. Act today; take a look online and then call us at (866) 447-2211. Mention this blog post and get an additional 5% off.

Listen to the podcast version

By Lorraine Schnelle, CPA

In my last blog post we talked about the learning pyramid, which depicts average retention rates based on the type of learning activity. Today, let’s talk about how you can determine the types of learning activities you’ll need as it relates to a staff member’s educational needs.

CCCQ Scale

Below is my very own handy litmus test, the “Compliance, Complexity, Change and Quality Scale,” or my CCCQ Scale. This test helps me understand the big picture of an educational need. Use this scale to evaluate each educational situation and then read my suggestions at the end of this post, based upon your results.

Compliance: Is this a compliance issue? If it is, draw a line on the Compliance scale. Where you put that line depends on the “risk” that you feel this issue has with regard to the organization. For example, if this is a new compliance issue and it relates to a large number of staff members, place your mark near the “high” end of the scale. However, if it relates to a small number of staff members, then place your mark closer to the center. If it is a compliance issue that is not new, but rather a refresher, place your mark between the low and middle section. If it is not a compliance issue, don’t place a mark on this scale at all.

Change: Is this related to a change in process, procedure, technology, etc.? If it is, put a line on this scale based on the significance/breadth of the change. For example, let’s say you are implementing a document scanning system for the first time in all patient access areas. This involves new technology and process education – this is a significant change so place your mark closer to “high” end of the scale. However, if you are changing the dress code policy, even though that can be controversial and cause issues, mark this change on the “low” end of the scale. Again, if this educational need is not related to a change, don’t place a mark on this scale.

Complexity: What is the level of complexity? Ask yourself these questions to help you determine where to place your mark:

• Is it a new concept or issue?
• Is it a unique industry concept or issue?
• Are there many steps that need to be understood?
• Are there terms and expectations that require explanation?
• Have there been other educational activities on this concept or issue in the past?

These are just a few suggestions. Take some time to ponder and come up with your own questions, and determine where your mark should be on the scale. You should have a mark somewhere on this scale.

Quality: Is it a quality issue? If so, ask yourself “do you have quantifiable information that this is a quality issue?” Notice the word “quantifiable.” You may get verbal feedback from a staff member that there’s a “quality” issue, such as there’s been discrepancies noted in patient addresses. This is not enough to make a mark on this scale. You need to take the time to validate the “quantity” or “volume.” That is what you are going to document on this scale – is it “high,” “low” or somewhere in between?

Results

Now that you have all your “marks” on the CCCQ scale, step back and look at the big picture.

• If you have more marks on the “high” end of the scale, this means you should consider a variety of delivery methods and tools as you create the educational activities to support the end result.
• If your marks are on the “low” end of the scale, most likely -
  • One educational tool will meet the need.
  • A large-scale educational initiative is not required. Rather, additional research is needed to identify the individuals that need the education.

Next week, my blog post will talk about “the end game” – making sure we understand the objective of the educational activity and ensuring we stay on target.

Thanks for stopping by and happy training!