What you need to know to build an effective team
Customer service teams within revenue cycle, like all teams, have changed dramatically over the years. There are tremendous expectations placed on customer service teams to clearly respond to, explain and resolve complex patient questions and concerns. Your customer service is the triage team for everything revenue cycle. They face an ever-changing array of questions that often originate from a patient statement from the healthcare organization.
Members of this team need to be well versed in the front, middle and back-end revenue cycle, but they also need to think on their feet when they receive clinical questions and concerns. Many questions can be answered directly while accessing patient information within your EHR. However, some questions require that your team function as a traffic control center representative. There are multiple points of entry, endless routes a problem can take, and countless departments seek information from to close out a request. In short, in the world of customer service, one question often leads to multiple questions.
Let’s examine some of the most important pieces of the puzzle, that is customer service and how to ensure your team is a highly effective team.
The Basics
Customer service truly lives in an 80/20 world. On one side, 80% percent of the requests they process are routine and repetitive, while the remaining 20% can be questions that are posed once a year or less. So how do you navigate the 20%? While it is not practical to create an SOP or a Tip Sheet for the hundreds of scenarios and questions patients can present, there are some building blocks you must have in place for your team to be effective.
First, create a sole source location for SOPs, Help Guides, Tip Sheets, P&Ps, etc. that your customer service team can easily access to answer questions and resolve issues. Assign your team leader, supervisor or manager with the responsibility of maintaining all documentation housed in the source, and ensure the documentation is reviewed at least twice per year.
Note that different doctors, hospitals etc., may have varying guidelines, for example, the Doctor in office “A” may have different protocols compared to the Doctor in office “B”.
For the 20% or less that you do not have a written process or policy for, create guides that can be used for the representative to begin with. Document role playing scenarios are a great tool for those “we do not have a process for that request”. Incorporate role-playing scenarios in your customer service meetings and have the team share “unusual” requests regularly and the steps they took to resolve them. Finally, the team must have a road map for clinical questions. We all live by the golden rule of detailed notes on accounts we service. The goal is for anyone else with access to the notes for a patient’s record to clearly understand the question/concern/dispute and know the status of the problem.
If a problem is referred to a clinical area, make sure there is follow-up between the patient and customer service to verify that the patient’s concerns were addressed. Create a “We Own It” mentality and culture within the customer service department. Team member feedback is essential for continuous improvement and enhancing the unit’s toolkit. Keep a log of customer service issues to ensure that common problems are promptly addressed and resolved, rather than allowing them to persist.
Challenges and Obstacles
For so many organizations, customer service is the “throw it over the fence” department. This is especially true with moving accounts between work queues. Understanding what is moving in and out of customer work queues is a department-wide responsibility. Work queue logic must be evaluated annually at the minimum. Additionally, provide detailed feedback on any misuse of work queues to your colleagues.
Staff morale – One of the most frustrating aspects of being in the role of customer service representative is not an angry patient, it is the inability to find the appropriate documentation to guide them to the resolution of the problem. Even if the documentation isn’t specific to customer service only, make sure that your team has a copy in their repository and does not have to look in other locations such as follow up, biller, coding, etc. Another challenge healthcare systems face is customer service can be one of the first departments to identify a negative trend, but little is done to address the trend. Having a full proof plan to address those trends not only helps your patients, but it will also instill loyalty in your team members.
Goal Setting and Team Recognition
In many organizations, customer service is the first impression of the system post date of service. Patients can have a wonderful clinic or hospital experience but then have a negative opinion of the system based on “billing nightmares” or “errors” and customer service is the department that must quickly reinforce the systems commitment to patient satisfaction. Take the time to recognize your top performers when they go above and beyond to resolve a patient’s concern.
Customer service representatives must genuinely enjoy assisting others. Be sure to have levels of growth and position established in the unit. The highest-level team members of the customer service unit are truly an extension of management. Utilize their experience in training new team members, representing the department in larger PFS meetings and challenging them to actively participate in the continuous improvement and effectiveness of the unit.
Conclusion
Health systems experience high turnover at times, and customer service departments are no exception. To establish the most effective team, and to avoid burn-out, you must take the time to invest in their toolkits. Seasoned customer service representatives in healthcare are worth their weight in gold. Whether the initial communication is from a phone call, a text, a MyChart inquiry, or administration referral, having the team armed with what they need to interact positively with your patients is the key.
Additionally, a thorough examination of your existing customer service department structure will ensure that processes run smoothly, and objectives are met. Our consulting service helps clients navigate departmental challenges and streamline processes to effectively address and fulfill staffing requirements.
Author: David Brown, Director Consulting Services, Healthrise.
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