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Froedtert Boosts Patient Financial Engagement, Point-of-Service Collections

News  |  By Christopher Cheney  
   December 14, 2017

Wisconsin health system trains registration and scheduling staff to conduct sometimes-difficult financial conversations with patients.

Training physician-clinic registration and scheduling staff to have financial conversations with patients has doubled the rate of point-of-service copay collections at Froedtert and the Medical College of Wisconsin.

"It's been a big jump. From the mid-30s to almost 70%," says Jon Neikirk, executive director of revenue cycle at the three-hospital, Milwaukee-based system.

Financial Engagement Department Leads Change

Froedtert’s training initiative, launched a year ago, is modeled on the Healthcare Finance Management Association's Patient Financial Communications Best Practices.

One of the first steps in the initiative was to create a new revenue cycle office, the Financial Engagement Department. The three-member team has a director of financial engagement, a project manager, and a trainer, and its annual staffing cost is about $250,000, Neikirk says.

Creation of the Financial Engagement Department was necessary because Froedtert's revenue-cycle team did not have a significant leadership role for registration and scheduling staff.

"Registration staff and clinic leaders were not well-versed in financial communication," he says. "We needed to provide support to our health system leaders who managed the staff who were going to be having these conversations."

The Financial Engagement Department plays a key role in training and supervisory support. Its responsibilities include:

  • Development of training material
  • Providing supervisory reports for registration and scheduling staff leaders
  • Teaching supervisors how to hold their staff members accountable
  • Conducting training sessions, including remedial training

Teaching Role

Training for registration and scheduling staff features e-learning courses as well as in-person instruction. The curricula was set in accordance with the HFMA Patient Financial Communications Best Practices.

Veteran registration and scheduling staff as well as new hires have been required to take as many as three financial communication e-learning courses, Neikirk says. The courses focus on the three clinical settings listed in the HFMA best practices:

  • Time-of-service financial communications in the emergency department
  • Time-of-service financial communications in settings outside the emergency department
  • Financial communications prior to service for scheduling staff

Role-playing is a crucial element of in-person instruction for registration and scheduling staff because it helps frontline employees develop a comfort level with financial communications, he says.

It focuses on scripting for financial conversations such as a patient's copay responsibility and the availability of financial assistance. The Financial Engagement Department's director crafted the scripting. For the role-playing exercises, the Financial Engagement Department's trainer plays the role of patients.

The most challenging role-playing scenarios include the trainer acting in the role of patients who have difficulty paying copays, Neikirk says. These scenarios include patients who say they can't pay, patients who say their insurance will pay, and patients who ask to be sent a bill rather than pay at time of service.

In addition to teaching staff members how to handle financial conversations, role playing reinforces best practices for more general communication skills.

"We want to make sure that the registration staff are not stumbling over their words and that they are making eye contact," Neikirk says.

Communicating with Patients

Registration and scheduling staff also receive training in how to use a trifold billing brochure to acquaint patients with multiple elements of Froedtert's patient financial experience. Information in the brochure includes:

  • Financial assistance programs
  • An explanation of the health system's bifurcated billing for hospital services, with hospital and physician charges appearing on separate billing statements
  • Billing office phone numbers
  • Contact information for financial counselors
  • Types of insurance accepted at the health system

"For registration staff, they use the brochure as a guide," Neikirk says.

Staff use the billing brochure to point out information that is most relevant to individual patients, he says. For uninsured patients, registration staff highlight the financial counseling and financial assistance information. For insured patients, staff highlight the section of the brochure that explains how there are separate billings for hospital services and physician services.

The effort to train the health system's registration and scheduling staff to conduct financial conversations is ongoing and has yet to reach the $2 billion (revenue) health system’s flagship facility, 536-bed Froedtert Hospital in Milwaukee. Rolling out the new training and supervision at Froedtert Hospital, which is set to begin in January, is a challenge because of the large staff size and multitude of leaders who supervise them, Neikirk says.

"We started with our community hospitals and moved on to our academic campus with this training” he says. “It's still a work in progress."

Christopher Cheney is the CMO editor at HealthLeaders.


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