A Healthy Serving of Patient Experience

Nick McLaughlin, Ridiculously Nice Sales

Not less than ten years ago we had to train our collectors for the common complaint from the patient of, “My insurance is supposed to pay 100%”, but for most American’s those days are long gone. The more likely complaint is now, “How am I going to come up with the $5,000 deductible.” This article is going to dig into the expected “patient experience” as a healthy serving of self-pay has been served up to you by insurance companies. Patients who have never dealt with a health system have an expectation that credit cards, cell phone, cable, utilities and other consumer service centers have created. Will you live up to the expectations and create a “better patient experience”?


There are more opportunities to screw up the best way to do statements than earn praise for doing a good job. If your statements follow the recommendations of HFMA’s Patient Friendly Billing Initiative, and you send the three monthly statements that 501r requires, you are on the right track. But before we move on from the subject of statements, let us begin the war on over-statementing. Did I just make up a word? Maybe! But you know what I mean. Occasionally, we still run into hospitals that send 5 or 6 statements to each patient before the account goes collections. This is a completely unnecessary waste of money. Almost as bad as that is when a hospital that has just converted to a new system sends their patients one statement for their accounts in the old system, and a separate statement for their accounts in the new system, and the new statement doesn’t include the accounts that are still due in the old system!

Imagine if your credit card company upgraded their system and began sending you two different bills, one for your charges before February 1, when they converted, and one for your charges after February 1… Their customers would be up in arms! The moral of the story is: combine your systems. Patients are screaming for one experience whether they visit your doctor’s office, hospital, or ambulatory surgery center. If your name is on the door, then one consolidated patient friendly statement and payment plan should be established for the patient. We specialize in combining multiple entities and systems into a better patient experience. It will help your patients lower their blood pressure, save you money, and prevent your patients from getting so frustrated they go to your competitor down the street.

Ridiculously Nice Calls

Making timely, friendly (we call Ridiculously Nice) follow up calls, and making them efficiently, is where a huge opportunity to improve the patient experience and cash flow lies.

We recommend starting outbound phone calls to patients 35 days after the initial statement is sent. We have found that calling patients before the first month is up, even in a Ridiculously Nice manner, creates awkward conversations, because patients expect to be given until their due date to pay the bill (normally a month later). Another great reason to start calling at day 35 is because the patient likely received their second statement 2-3 days ago, so it should be relatively fresh in their memory.

After the initial call, we recommend calling every 8 days, excluding weekends, until you get in touch with the patient. The 8 day interval causes you to call on a different day of the week each time, increasing the likelihood of a connection. Once the patient is reached, let the Customer Service Representative decide what the next best action is based on their conversation with the patient (payment-in-full, payment arrangement, try back next Friday because that’s payday, etc.)

I’ve heard some hospitals express concern that their staff might not be treating patients as well as they should on the phone. Call quality assurance is extremely important, which is why we use and recommend a tool called CallMiner. CallMiner monitors every single call for elevated tone, abusive language, right party contact, and many other helpful metrics. It alerts a supervisor if an issue comes up, allowing leadership to help right the situation.

Remember before when we discussed being compared to credit cards, cell phone, cable, and utilities? These markets have experience providing great customer service to keep customer satisfied. Two of the main metric they track in their call center are abandonment rates and/or average time to answer. These two metrics will tell you if your customer service team is providing a better patient experience. Abandonment rate should be under 5% and average time to answer should be under 20 seconds. If you are not meeting these marks, then it is time to ask yourself if you are frustrating your patients.

Payment Plans

Many hospitals leave money on the table by setting up a payment plan with a patient, and then never touching it again, even if it becomes delinquent. There are two very helpful times to reach out to a patient on a payment plan: when that patient has a new balance added to their total, and when that patient misses a payment or pays less than agreed. We set up programming that monitors all payment arrangements in our care, and queues a phone call to either increase the payment plan when a new balance comes in, or catch up on the payment plan if a payment is missed or underpaid.


We have seen phenomenal improvements in the efficiency and effectiveness of our Early Out/Self Pay service by implementing these best practices: statement consolidation, follow up calls every 8 days starting at day 35, CallMiner for call quality assurance, and calling patients when they miss/underpay a payment plan or a new balance is added to their total. We hope you can capitalize on what we’ve learned by either implementing these practices in your billing office, or calling us to see if we can help you in that area!

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