Presentation on theme: "AAHAM WI Chapter Fall Conference"— Presentation transcript:
1AAHAM WI Chapter Fall Conference Customer Service: Handling Patient Billing Complaints Mayo Clinic Health System- Franciscan Health Care- SW WIAAHAM WI Chapter Fall ConferenceFriday, October 3, 2014
2Point of Contact for Complaints Most patient concerns come in through our Customer Service Call Center.Our previous process was to escalate the call to a Supervisor line that contained a voice mailbox. The patient was instructed to leave their information, a call back time and a contact number.Often the patient did not leave enough information on their voic to begin resolving the concern.Some staff routed calls as soon as the patient requested a Supervisor.We evaluated what we were defining as an escalated patient call.A tracking tool spreadsheet was created and maintained by the unit management staff who works the escalated calls.
3New Process We launched a new process in mid-June 2014. Our headsets were updated to allow staff to “plug in” to other co-workers phones.Experienced call center staff were identified to act as mentors.Office Communicator (instant messaging) was installed on computer desktops for all Patient Account Services staff.Scripting for staff was created.Staff will make an offer to the caller to bring a colleague onto the call to help with a first call resolution.
4Online FormAn online form was created for staff to complete. This eliminated the voice mailbox.Provides standard information for account reviewAllows us to track and measure resultsIt is used as a training tool for process improvement.It assists with routing care-related concerns to our Patient Experience Department.
5Results of New Process: July 2014:30% drop in escalated calls versus old processAugust 2014: 52% drop in escalated calls compared to old processSeptember 2014:On target for a 70% drop compared to old process
6Monthly TotalsThe Call Center averages 4,200 incoming calls per month.Averaged 27 escalated calls per month before new processAfter new processJuly escalated callsAugust escalated callsThrough September 14th- 3 escalated callsProjecting 6-8 escalated calls for September 2014
7Main Topics of Escalated Calls EUCC vs. Urgent CareExplain charges based on severity and utilization of resourcesReview insurance benefits and codingAgency TurnoverPatient upset their account was placed at an agency for collectionsQuestioning the type of service we billed (this may result in coding review)Preventative vs. diagnosticLab charges performed as part of a physical but coded with a diagnosis