CHAA Examination Preparation

Pre-Encounter – Session I

Pages 21-33

University of Mississippi Medical Center

What to Expect…

• This module covers various aspects of Patient Access knowledge found in pages 21-33 of the Pre-Encounter section of the 2010 CHAA Study Guide.

• A quiz at the end will measure your understanding of the knowledge covered.

Customer ServiceThe goal of Customer Service is simple:

Provide a positive healthcare experience in order to Create LOYAL customers who will REFER this hospital to their friends and family.

Patients will get sick again and they will discuss their UMHC experience with others. Whether or not they return to our facility, and whether they relay their experience in a positive light depends on their treatment by hospital staff.

Customer Service

• This module focuses mostly on strategies and techniques that lead to excellent customer service.

• You will learn tips and techniques that if understood and applied, will create loyal customers who positively describe their UMHC experience.

First Impression

• You never get a second chance to make a first impression. PATIENT ACCESS is often a patient’s first glimpse at UMHC.

• Their impression is the result of your ATTITUDE and BEHAVIOR towards them.

• In order to ensure you have the right ATTITUDE and BEHAVE in the correct way, pretend that all patients receiving treatment are YOUR LOVED ONES.

Internal vs. External Customers

Both Internal and External Customers work together in taking care of the patient.

• INTERNAL CUSTOMERS come from WITHIN the hospital (doctors, nurses, patient access, patient financial services, etc.)

• EXTERNAL CUSTOMERS come from OUTSIDE the hospital (suppliers, insurance companies, physicians, visitors, etc.)

Internal and External Customer Service

• Everyone involved in the healthcare process depends on one another. Therefore it’s paramount to build and maintain EXCELLENT RELATIONSHIPS with everyone involved in patient care.

• A harmonious atmosphere where departments GO OUT OF THEIR WAY to help other departments increases patient safety as well as customer service.

• INFORMATION SERVICES are a vital internal customer who makes sure our computers are performing optimally. Can you imagine your job without them?

The Goal of Customer Service

Excellent customer service in Patient Access:

• Demonstrates COMPASSION

• Ensures WAIT TIMES are kept to a MINIMUM

• Is ACCURATE and ACCOUNTABLE with the information collected

Handling Complaints are Always a Part of Customer

ServiceWhen dealing with an unhappy customer, ask

these three questions:

1. What is the concern?

2. What have you (the customer) done to address the concern?

3. What would you (the customer) like to see as an outcome?

Handling Complaints

• You should make every effort to resolve customer complaints yourself at the UNIT LEVEL.

• When an issue arises that you are unable to resolve, notify your supervisor IN WRITING.

Increasing Patient Safety• Patient safety is increased when patients are made

PARTNERS in their own healthcare.

• Patient Access helps do this by EDUCATING patients concerning their RIGHTS and RESPONSIBILITIES.

• This is done by giving them PRINTED MATERIALS in their OWN LANGUAGE in no smaller than 12 point font.

• Present patients with materials UPON ADMISSION.

Research Shows…• COMPASSION is as significant as COMPETENCE in

creating a positive healthcare experience.

• Patients will put up with MARGINAL AMENITIES but have a low tolerance for IMPERSONAL CARE.

• You demonstrate compassion by:– Smiling– Making eye contact– Being Courteous (allowing visitors to enter

elevators before you, etc.)

Understanding Communication

Communication is a successful EXCHANGE of INFORMATION, not a simple exchange of words. According to the chart below, how much of communication is talking?

Communication• In communicating with others, most people

don’t realize that what you say is not as important as HOW YOU SAY IT.

• Nonverbal Cues such as your posture, eye contact, and facial expressions SPEAK LOUDER THAN YOUR WORDS.

• Sitting up straight, looking patients in the eye, and smiling tells them THEY ARE IMPORTANT, YOU RESPECT THEM, AND YOU WANT TO HELP.

Above and Beyond• The most appropriate way to help a patient

who asks for directions is to ESCORT THEM TO THEIR DESTINATION.

• When communicating with patients, you must obtain FEEDBACK from them to ensure your message was correctly received.

• Avoid using SLANG or MEDICAL JARGON that the patient will not clearly understand.

Language SpecificsCommunicating information can be broken down into

three categories.

• ENCODING- SENDING the message (writing a letter, typing a text message, using sign language, etc.)

• TRANSMISSION- the MEDIUM through which you send the message (letter, phone, hands, etc.)

• DECODING- when the receiver INTERPRETS the message

Nonverbal Communication• Nonverbal cues are PARAMOUNT in

communicating with patients.

• They give you clues about what the patient is thinking/feeling which allows you to adjust your message to meet them where they are.

Communication Barriers• Communication Barriers are figurative walls that

prevent communication from occurring.

• Common barriers are anything from a foreign language, to prejudice, to being too busy, stereotypes, distrust, etc.

• Barriers can exist on behalf of the patient or the patient access specialist.

• PARALANGUAGE is a barrier relating to the tone, volume, pitch, quality, and range of speech.

Overcoming Communication Barriers

• Navigating communication barriers takes DIPLOMACY, TACT, and PATIENCE.

• When language is the barrier, avoid using FAMILY MEMBERS as translators.

• Apply HEAT to the difficult communication situations:– Hear them out– Empathize with them– Apologize for the inconvenience– Take responsibility for action

Open-Ended QuestionsOpen-Ended Questions should be used when

interviewing patients because they:

• Force the patient to make their own response

• Elicit more than a yes/no answer

• Typically begin with: Who, What, When, Where, Why & How.

Communication Aids

• REFLECTING ensures accuracy by asking the patient to repeat what they heard.

• PARAPHRASING is when you repeat what the patient said in your own words.

• ALL PATIENT PROBLEMS are a big deal because they ARE A BIG DEAL TO THE PATIENT.

Technical Competence

Patient Access Associates are technically competent when they are able to:

1)Ask the appropriate questions for completing registration and verifying insurance.

2)Answer patient questions as they relate to registration and billing.

3)Complete the registration process with a high level of accuracy.

Can You Please Everyone?OF COURSE NOT!

BUT

Patients will gauge a staff member’s care by THEIR PERCEPTION of whether or not the staff MADE AN EFFORT to understand their UNIQUE SITUATION.

Therefore, make sure the patient sees all the work you do TO PROACTIVELY CATER TO THEIR NEEDS.

HIPAA

The Three Goals of HIPPA are to:

1)Protect Patient’s Private Information2)Encourage Electronic Transactions3)Require safeguards to protect the

security and confidentiality of personal health information

Remember Who You’re Talking To

• When exchanging information with patients, you are to account for AGE SPECIFIC CONSIDERATIONS to guide your interaction with the patient.

• You wouldn’t treat a four year old the same as you would a 44 year old.

• You must understand how to interact successfully with patients of all ages.

Age-Specific Considerations

• School children should be given as much control as possible and involved in the conversation when appropriate.

• The most important thing to adolescents is PEER ACCEPTANCE and you should OBSERVE THEIR BODY LANGUAGE for cues about how they really feel.

• Always maintain eye contact with ADULTS and remember that they may have many responsibilities (job, kids, aging parents, etc.).

• Address SENIORS as Mr./Mrs. Last Name and be mindful that they may not process information as quickly as they used to.

EMPATHY

EMPATHY means understanding the pain of another and/or sympathetically hurting along with them.

The Research is Clear. According to a Press-Ganey Survey:

• EMPATHY plays a major impact on a patient’s impression of a hospital.

• If you’re going to provide excellent customer service, you’ve got to DEMONSTRATE EMPATHY and COMPASSION.

Financial Facts• Hospitals provide medical care regardless

of race, creed, color, sexual orientation, disability, age, or the ABILITY TO PAY.

• If patient is enrolled in MEDICARE or MEDICAID, they should PRESENT A CARD at the time of registration.

• Their information can also be found on the website.

Insurance• Patients with healthcare insurance should also

present a CARD at time of registration.

• Most will DEPEND ON YOU to verify coverage and inform them if hospital staff members are OUT-OF-NETWORK and therefore will be more expensive for them.

• PATIENT FINANCIAL SERVICES normally handles monthly payment plans and investigates possible financial assistance.

Customer Literacy and Comprehension

It’s vital that customers are able to READ and UNDERSTAND all the information you present to them.

ASKING QUESTIONS does two positive things:1. It confirms whether or not the patient understands.2. It gives the patient a chance to speak up and participate in the interview.