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How to Boost Post-Discharge Revenue, Customer Service

Steve Levin, for HealthLeaders Media, October 8, 2010

When most healthcare executives talk about customer satisfaction, they focus on the days before and during clinical treatment. The fact that customer satisfaction is a topic on executives' minds is great. But why does the focus stop at discharge?

For many patients, contact and interactivity with the hospital will continue on in the business office for many months or even years. There will be multiple rounds of communication regarding benefits, payment responsibility, and balances due; there might be outbound and inbound phone calls; and there will definitely be multiple hospital resources and hospital service partners involved. 

The result of executives disproportionately focusing their attention to the processes before and during treatment is having exactly the impact you would expect on the back end phases. Back-end processes are the organization's satisfaction laggards. In fact, the typical business office process is structurally set up to erode customer satisfaction. Processes are set up to lower costs and ignore almost all the basic rules of customer service, loyalty and personal connection. We are treating all customers basically the same.

Typically, every patient with payment responsibility after insurance gets the same letter, the same message, the same phone call. The same applies to the uninsured patient. Sometimes, there is not even a difference between the uninsured and the balance after insurance letters. All customer calls are handled by the same customer service teams, with the same training and same objective—to collect as much cash as they can, as quickly as possible.

No clinician's practice would ever accept this approach. Clinical practices tailor standard treatments to the patient's unique situation. Based on the presenting conditions and the situation of the patient, clinicians adjust the sequence of treatments, the location, and even the timing.

Outside of healthcare, businesses that sell to consumers recognize that people are different and those differences are, in fact, opportunities. They are opportunities to create loyalty; opportunities to reduce operating costs; opportunities to increase revenue. Moreover, consumer businesses recognize that post-sales support is a critical lever to accomplishing these objectives. All of a company's interactions impact the consumer perception and willingness to repurchase.

Why is healthcare different?

In the business office, the consumer is known as self-pay. Self-pay is that revenue stream no hospital or physician really wants to deal with. Self-pay generates all the bad debt, costs too much and takes too long to collect. These realities have created an atmosphere in which customer service is viewed as a necessary evil as opposed to a business opportunity.

Unfortunately, self-pay is also the revenue stream that is growing the fastest and will become paramount to hospital success in the future. Health reform is likely to accelerate this phenomenon as most patients will experience larger deductibles, more uncovered procedures, more co-payments and occasionally coinsurance. Whereas the true uninsured numbers will fall, almost every other patient will suddenly become a balance-after-insurance account.

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