Dedicated Bill Pay – Colleague

Reviews Inquiry

  • Patient call to question charges, clarify balances or confirm payments.
  • Voicemails are left with issues requiring callbacks.
  • Manually accesses the relevant account(s) in Cerner.
  • Investigates the issue and verifies account details
  • Works with patient to update personal information and coordinates with insurance providers as necessary.
  • Interacts with internal systems, like Cerner and RevSpring, to manually update information in the system as needed.
  • Documents each interaction thoroughly to avoid repeating steps based on repeat calls being common.
  • Manually identifies and reallocates payments when errors arise.
  • Reissues corrected statements as needed.

Escalates Complex Issues

  • Escalates complex issues, such as multi-entity billing errors or misapplied payments, to senior staff.
  • Reviews multiple systems (e.g., Cerner, bank records).
  • Cross-references accounts.
  • Collaborates with other departments.
View Technology Map

Step

Technology/Touchpoints
Reviews Inquiry
  • Phone
  • Cerner
  • RevSpring
  • FollowMyHealth®
  • Experian
Escalates Complex Issues
  • Phone
  • Cerner
  • RevSpring
  • FollowMyHealth®

Step

Pain Points
Reviews Inquiry
  • High call volumes lead to long wait times, requiring many patients to leave voicemails. Staff often struggle to return calls promptly, further exacerbating patient dissatisfaction.
  • Patient must contact the billing office directly to make personal information changes, as the current system does not allow for seamless updates through the portal.
  • If patient loses their billing statement, they must contact support to retrieve a new Easy Match code, adding manual effort for staff and causing delays.
  • Patient and staff experience delays in correcting information, which may result in billing errors or insurance claim denials.
  • Patient is confused and often frustrated, which increases call volumes and delays payment processing. Staff resources are further strained, as they must manually resolve issues that a better system could automate.
  • Patient paying partial amounts cannot see updated balances, causing them to contact support for confirmation, which is unnecessary.
  • Staffing reduced by 40, causing an 8% call abandonment rate (up from 2% prior to layoffs) based on wait times, impacting the entire revenue cycle.
  • Although IVR systems were available in previous platforms like Epic, the current portal lacks this feature, forcing patient to either use the portal or call support for payments.
  • Prepayments for procedures are frequently misapplied to the wrong account. This adds unnecessary complexity for patient and administrative staff, increasing workload and dissatisfaction.
Escalates Complex Issues
  • Patient must contact the billing office directly to address incorrect charges, which adds extra steps and complexity to the payment process.
  • Each billing entity generates its own statements, requiring patient to engage with multiple representatives for resolution, as well as manual effort to locate and reconcile patient information. This often results in duplicative efforts, inconsistent information and prolonged resolution times.
  • The complexity of separate account numbers for an individual encounter overwhelms patient and staff, increasing call volumes and delaying resolution.
  • Payments made for one family member may be misapplied to another, and account details are not readily accessible across all family members. Staff must manually link these accounts, adding inefficiencies.
  • Missed payments and partial resolutions are common, creating extra work for customer service staff to resolve issues and increasing patient dissatisfaction.
  • Payments made with outdated statement numbers result in credits being applied to the wrong account. Resolving these errors requires staff intervention.

Step

Thinking

Feeling
Reviews Inquiry

“How can I resolve this efficiently and keep the patient calm?”

“There’s got to be a better way to do this.”

“My usual approach isn’t fixing it; will need to escalate.”

Overwhelmed by high call volumes and system inefficiencies.
Escalates Complex Issues

“How can I streamline workflows for recurring issues?”

“What system/department do I need to access to address this?”

“How do I minimize patient dissatisfaction?”

Pressured

Step

Opportunities
Reviews Inquiry
  • Combine all billing-related inquiries into a single call center for the entire health system.
  • An automated system could cross-check patient records with billed services to ensure accuracy. This minimizes errors and the need for patients to dispute charges.
  • Enable automated payment confirmation emails. Automated notifications will reassure patients that their payments were received and processed, alleviating concerns about payment accuracy or delays.
  • Enable an interactive voice response system for automated phone payments. Patients will no longer need to speak with staff for simple payment tasks, reducing call volumes and improving user convenience.
  • Create a dedicated prepayment contact line. A clear and visible contact method for prepayment questions will prevent confusion and delays in resolving issues with pre-applied funds.
  • Enable the portal to reflect payments and balance updates immediately after processing.
  • Replace static monthly statements with digital statements that update as account activity occurs.
  • AI systems would cross-check payment entries against existing records to flag inconsistencies before payments are posted. This will eliminate manual intervention for common errors.
  • Deploy a virtual assistant to handle common billing inquiries through the phone or portal.
Escalates Complex Issues
  • Expand Escalation team training. Escalation staff would receive detailed training on navigating fragmented systems and resolving multi-entity issues, ensuring consistent and accurate support. These teams will be empowered to resolve even the most complex cases without delays.
  • Include a link on billing statements to FAQ about managing multiple accounts.
  • Use machine learning to match payments with intended accounts automatically. Automated systems can analyze payment patterns and detect misapplied funds, ensuring corrections occur without staff intervention.
  • Develop a fully integrated digital platform that centralizes patient account management; combines medical, billing and appointment records into a single user-friendly interface; and includes features, like real-time payment updates and family account management, to minimize the need for staff intervention.
  • Develop family account aggregation. By allowing a parent or guardian to view and pay bills for multiple family members in one portal, staff will field fewer questions about disconnected accounts, improving response times for other inquiries.
  • Create a prioritized callback queue. Patient can leave their contact information and choose a callback option while maintaining their place in line. This improves their experience while allowing staff to work through calls more efficiently.
  • A standardized cheat sheet for navigating Cerner and related systems would help staff quickly access account information across billing entities. Consistency reduces the time needed to resolve patient inquiries.
  • Establish an escalation path for multi-entity Issues. When a patient’s inquiry involves multiple accounts, staff can forward the case to a specialized team for resolution. This prevents delays caused by staff navigating multiple systems or passing the issue around.
Contact Us View Supporting Documents