This presentation will review strategic initiatives for revenue cycle leaders to further engage patients in their care experience – beginning before they enter the hospital’s front door. The session will present key strategies and related outcomes in patient satisfaction, staff performance, reimbursement and upfront patient collections. • Ensure meaningful upfront encounters with Patient Access – at each and every encounter. • Hardwire measurable standards throughout Patient Access teams. • Reduce process time and eliminate duplication for quicker patient turnaround. • Ensure consistent practices across hospital entities and among associates. • Avoid financial harm through automated documentation. • Protect staff through documentation integrity. • Increase visibility of – and access to – critical patient touch points across the organization. Leading the development of Texas Health’s Patient Access infrastructure, Patti Consolver and Scott Phillips oversee the centralized patient access intake center and the patient access departments for the system’s 13 wholly-owned hospitals.

1. “New Ways to Improve the
Patient Experience: Because It
Begins Before the Front Door”

2. TraceCommunication.com
“New Ways to Improve the
Patient Experience: Because It
Begins Before the Front Door”
Patti Consolver, Senior Director of Patient Access
Scott Phillips, Senior Director of Patient Access
Texas Health Resources

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Today’s Webinar Agenda
• Housekeeping Items
• Introduction of Speakers and Presentation
• Q&A Session

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Today’s Presenters
Patti Consolver, CHAM
Senior Director, Patient Access
Texas Health Resources
Scott Phillips, CHAM
Senior Director, Patient Access
Texas Health Resources

8. “New Ways to Improve the
Patient Experience: Because It
Begins Before the Front Door”
Patti Consolver, Senior Director of Patient Access
Scott Phillips, Senior Director of Patient Access

9. About THR
Includes more than 20,500 employees working in 24
acute-care and short-stay hospitals that are owned,
operated, joint-ventured or affiliated with THR
Texas Health is one of the nation’s largest faith-based,
nonprofit health care delivery systems.

10. About THR
Serves 16 counties in the Dallas-Fort
Worth area of north central Texas, home
to more than 6.2 million people

11. Learning Objectives
1. Consolidate pre-service communications to a
single touch point to reduce confusion,
duplication and inconvenience for patients.
2. Identify common patient complaints with pre-
service activities and update processes to
resolve the issues.
3. Record conversations in pre-service areas for a
complete picture of the patient’s experience
from first encounter to the point of admission
and beyond.

12. Today’s Agenda
• Review THR’s patient experience strategy
• Describe the role patient access plays in the overall
patient experience
• Consider the benefits of a centralized model for patient
access services
• Review industry best practices for patient financial
communications
• Describe challenges that drove THR’s need for change
• Review the process we implemented
• Review benefits realized and lessons learned

13. Our Patient Experience Journey
• Goals & progress
• Key players
• Role of Patient Access

14. Patient Access Model

15. Schegistration
• Centralizing pre-registration and insurance
verification
• Eliminate redundancies by partnering
scheduling & pre-registration processes
– Reduce number of calls to the patient
– Optimize flow for patients by reducing duplication
– Eliminate rescheduling/cancellations

21. Schegistration
• Streamline patient access to the system to
improve the overall experience
– Schedulers conduct a warm transfer to the Patient
Access Intake Center (PAIC) to complete call
– Documentation standardization – including
authorization, scheduling and registration info

22. Challenges Faced
• Patient complaints often led to he-said, she-
said scenarios
• Inability to determine root cause
• Lack of standardized training for staff on how
to resolve the issues
• Effectiveness of handoff between scheduling
and PAIC

23. Our Journey
• 2002: Began recording insurance verification phone calls
– Established proof of patient coverage for reimbursement
• 2007: Opened Patient Access Intake Center
– Centralized insurance verification and
pre-registration activities
• 2009: Began recording phone calls with patients at the
point of scheduling and pre-registration
– Expanded from system already used to record authorization
phone calls with payers
• 2012: Began recording in-person conversations with
patients at registration
– Entire patient access experience is recorded. (Scheduling, Pre-
registration, Verification, Face-to-Face at Registration.)

24. Recording Patient Interactions
• Step 1: Scheduling
– Record patient and/or physician phone call
– Capture faxed physician order
– Document patient information
– Screen for risk
• Right procedure
• Right order
• Right physician

25. Recording Patient Interactions
• Step 1: Scheduling
• Step 2: Pre-Registration
– Patient demographics
– Benefits and eligibility
– Self-pay estimates
– Scheduling instructions
– Directions

26. Recording Patient Interactions
• Step 1: Scheduling
• Step 2: Pre-Registration
• Step 3: Insurance Verification
– Correct authorization
– Correct status
– Confirm for appeals

27. Recording Patient Interactions
• Step 1: Scheduling
• Step 2: Pre-Registration
• Step 3: Insurance Verification
• Step 4: Face-to-face at Registration
– POS collections
– Financial counseling
– Bedside registration in ED

28. Recording Patient Interactions
• Step 1: Scheduling
• Step 2: Pre-Registration
• Step 3: Insurance Verification
• Step 4: Face-to-face at registration
• Step 5: Indexing and retrieval

29. Indexing and Retrieval
• Index recordings to patient account
• Establish audit trail for every encounter
• Complete picture of a patient’s pre-service
experience – from the initial encounter at
scheduling to the point of admission

30. Process Improvements
• Identification of common indicators
– Asked for the same information – address, phone
number, etc. – multiple times
– Told wrong location for a procedure
– Given inaccurate instructions
– Told different copay during different conversations

31. Process Improvements
• Identification of common indicators
• Service recovery
– Responding to negative surveys
– Addressing patient complaints
– Identifying risk opportunities
– Identifying training opportunities

32. Process Improvements
• Identification of common indicators
• Service recovery
• Staff training
– Proactive monitoring: 10 recordings/month
– Identifying outliers
– Conducting employee evaluations
– Providing 1-to-1 training
– Self-training; replaying interactions

33. Process Improvements
• Identification of common indicators
• Service recovery
• Staff training
• Drilling down
– Eg., Compare length of admission encounter for
pre-registered vs. walk-in patient
– Eliminate duplication to optimize flow for patients

34. THR Pilot Project
• Leadership Retreat: How can we improve?
• Pilot project
– Make a change
– Test and monitor impact
– Roll out across organization
• Eg., recording of mammography patient’s
registration experience; what we learned

35. Next Steps at THR
• Further implementation of best practices
• Expand on pilot project
• Implement quality scoring tool
– Measures
– Scorecards
– Reports

36. Quality Scorecards

37. Reports by Criteria

38. Scorecards by Department

39. Process Overview
Scheduling
Communication management system
records & indexes the calls/conversations
If there is ever a complaint,
administration can review the
patient’s entire experience to
identify the problems
The recordings also provide a
valuable training tool for
allowing staff members to hear
their own mistakes
Texas Health is able to drive new initiatives
that improve patient satisfaction
Pre-Registration Insurance Face-to-Face

40. Patient Financial Communications
Release of new industry-wide best practices for improving
and standardizing how healthcare organizations
communicate with patients about financial issues
Best practices developed by group representing
healthcare organizations, physicians, payers, and patient
advocates
Healthcare organizations have the opportunity to achieve
adopter recognition to demonstrate core commitment to
best practices
Best Practices Released Oct. 2013

41. Best Practices
“These common-sense best practices
bring consistency, clarity, and
transparency to patient financial
communications, and outline steps to help
patients understand the cost of services
they receive, their insurance coverage,
and their individual responsibility.”
Patient Financial Communications

42. Patient Financial Communications
Emergency Department
Time of Service (Outside the ED)
Advance of Service
All Settings
Measurement Criteria
5 Key Areas:

43. Time of Service
Pre-Registration Discussions
Maintain a thread of registration, insurance
verification and financial counseling discussions
If these discussions took place during
pre-registration, no need to repeat

44. All Settings
Incorporate compassion, patient advocacy
and education in all patient discussions
Use standard language to guide staff in
common types of discussions
Resolve issues face-to-face when able

45. Conclusion
• The experience begins before the front door
• Benefits of a centralized model
• Patient financial communication best practices
• Recording provides valuable insight for change
• Monitoring and measuring impact of change

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Questions?
Please submit questions using the Q&A
section in the participant panel.

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Thank you!
Blair Wright
blair.wright@twsg.com
The White Stone Group, Inc.
Patti Consolver
patriciaconsolver@texashealth.org
Texas Health Resources
Scott Phillips
scottphillips@texashealth.org
Texas Health Resources