Three Often-overlooked Ways to Boost Medical Practice Customer Service

We've all experienced the good and the bad in customer service situations.  We know the companies that can deliver, and the ones to avoid at all possible costs.

Within your practice, there are several departments. Each department delivers a customer service experience to patients. Implementing processes to cultivate great customer service in each of these departments is critical.  

Here are a few tips:

• Call patients when insurers provided poor benefit information.
Follow claims through the payment process and check to make sure they are paid like you were told they would be paid from the insurance representative. This is particularly important if you have a patient coming in for multiple visits. Seeing if the patient really owed a $10 copay instead of a 30 percent coinsurance can be a huge difference in a happy customer, or a confused and unhappy one. 

It's not your staff members' fault if they are quoted incorrect insurance benefits, but when they know the insurance will be paying differently, it's best to pick up the phone and call the patient, immediately.  Your staff can simply explain that the benefits the representative quoted are not the way the insurer decided to process the claim and the patient will be getting a bill for the difference. 

Your staff can “invite" the patient to call his insurance company to ask why the benefits were paid differently.  The patient is welcome to pay the difference on the phone with your staff, or at the office at their next visit if he does not want to receive a bill.

• Inform the front-office staff about claims problems.
Once the billing department realizes a claim has been paid differently, it should inform the front-office staff where the patient is being seen.

That way when the patient returns to your practice, the front-office can start collecting correctly, and the patient will receive no “surprise bills” in the mail. 

• Don't accept “verbally met” from a deductible or out-of-pocket standpoint. 
When your front office staff verifies a patient's insurance and the representative says that the patient has a $2,000 deductible with $532 of that met, you better believe that is the most accurate and up-to-date information available.  

If that patient then arrives at the practice and say something like, "Oh, I just had surgery, I've met that deductible,” don't disregard what the insurance representative has told you.

Hospitals or large organizations only bill once a month, in most cases, so if the patient had surgery on the second of the month, and comes to see you on the ninth, most likely those hospital bills are not even gathered up to bill out yet. 

If the patient says, “Well, I paid them money up front to cover my deductible,” it does not matter.  You have to collect that money from them, and the patient has to be reimbursed from the hospital or clinic where the surgery occurred. 

No, you cannot reprocess your claims; it does not work that way.  So, when a claim comes back and the patients swears she has met her deductible, you can “invite” her to call her insurance company again and confirm that he owes the amount processed.

Your staff may not like performing their jobs this way, but being up front and nipping these issues in the bud will save you thousands of dollars each year.  The patients who won't pay up front, are the same people you are sending to collections, and often don't end up paying at all.  Plus, do you think they are going to come back to see you? 

Be up front, be diligent, be nice, and put the responsibility back on the patient.  Remember, you are billing their insurance as a courtesy to them.