Chain Reactions

Goals are good for setting a direction, but systems are best for making progress. James Clear, Author

Are you tired and overwhelmed by the number of issues and problems your team brings to you to solve? Do you lie awake wondering how you’re going to plow through your current inbox filled with pleas or demands to fix a process breakdown, personnel issue, or revenue shortage? If so, read on . . .

The “Align, Act, Adjust” method that I introduced last time doesn’t just help align core values with operations. In fact, I have yet to work with a client who only derives that benefit after integrating it into their standard operating procedures. The real magic lies in all the other problems it solves including those sitting in your inbox and that of every other leader in an organization.

Clearing Obstacles

“Obstacles don’t have to stop you. If you run into a wall, figure out how to climb it, go through it, or work around it.” Michael Jordan

One of my healthcare clients formed an alignment team to align their patient intake process with the organization’s core values. During their work, they discovered a significant number of patients who showed up without having completed their insurance information. In the interest of keeping appointments on time, the administrative and nursing representatives on the team thought it best to send the patients through and let the checkout team collect the information at the end. However, the billing representative explained that doing so caused a massive backup at the checkout counter and the information collected was often incorrect because people were in a rush. In other words, the office was trading calm at the front end for chaos on the back and delays in the revenue cycle.

In addition, certain tests and services included in the appointments were not routinely covered by insurance which meant that those patients whose insurance was unknown were asked to sign a consent to pay if they opted to receive the service and their insurance rejected the claim. This not only slowed things down during the appointment, but also frustrated the doctors who were concerned that the quality of care was suffering for those patients who needed the additional test or service but refused due to the coverage issue.

Win-Win Plus

“Anticipation is the ultimate power. Losers react; leaders anticipate.” Tony Robbins

Leadership set the alignment team up to win by (a) ensuring that each of the stake holding groups were represented on the team, and (b) agreeing that they (leadership) would trust the team and its recommendations. ?Working together, the team came up with the following:

·????? Every time a patient makes an appointment, we will automatically send a link to their account to confirm their information or create a new account.

·????? We will ask our third-party developers to ensure that all insurance information is required before the patient can confirm their information and include a pop-up message that failure to provide insurance information will result in a self-pay appointment until coverage is confirmed.

·????? When the administrative team sends appointment reminders, they will confirm that insurance information has been received and if it hasn’t, remind patients that they will be considered self-pay until insurance is confirmed.

·????? If patients arrived at the appointment without complete insurance information, the administrative staff collected payment information at the time of check-in.

·????? If insurance information was provided but coverage for all tests and services had not been confirmed with the carrier, the office would still obtain consent to charge from the patient before administering the test or providing the service.

·????? One hundred percent of all self-payments will be refunded as soon as insurance information is received and the office will process claims from that zero balance.

The leadership team was prepared to accept this proposal until . . .

BONUS Wins

Because the team worked so closely with one another, they developed greater understanding and empathy for one another and their roles within the organization . So before the leadership team could act on the initial proposal, the team modified it with the following additions:

·????? In addition to the appointment reminder, the administrative team offered to call patients who did not respond to the reminder and take the insurance information over the phone. “What a great way to lean further into our desire to show kindness and foster trust with our patient population,” they said.

·????? The insurance team offered to expedite any confirmation of coverage received before the appointment date. “We don’t want to slow down the appointment process if we can help move it along smoothly and eliminating the need for that form will improve the patient experience as well as give our doctors comfort that they aren’t compromising the standard of care by avoiding these tests or services.”

o?? And, because the insurance team was able to confirm coverage for those services, any patient whose insurance would not cover them knew at their appointment and could pay at the time of services thereby eliminating the need to submit a claim and wait for it to be denied which often took 60-90 days at least.

Net wins

“Exceeding expectations is where satisfaction ends and loyalty begins.” Ron Kauffman

If you’re keeping score at home, here are the benefits that this two-week exercise netted:

1.??? Problem solved: What do we do about patients who show up without having provided insurance information in advance?

2.??? Solution created: Patients who show up without confirming insurance information will be considered “self-pay” until insurance can be verified, and we will refund their payment in full.

3.??? Alignment:

a.??? The team aligned the organization’s core values of “Kindness” and “Trust” to ensure that patients were given frequent opportunities to provide the requested information including personal calls from the office which they used to establish a relationship with the patients.

b.??? The team developed greater understanding, empathy and trust for one another and the other roles within the practice which fed another core value of “Teamwork.”

4.??? ??Bonuses:

a.??? The people responsible for administering the processes at issue created the solutions which meant instant buy-in from their teams as opposed to mandates being handed down by leadership.

b.??? Leadership did not have to solve the problem rather, they were the beneficiaries of the solution, the camaraderie formed among the participants, improvements to the revenue cycle, and eliminating waste in their team’s claims submission process.

What’s Next?

If you’re a leader whose inbox is flooded with requests to fix problems in your organization’s operations or processes, create an alignment team and empower the stakeholders to create their own solution. Yes, it requires you to reinvest some time back into your organization's own health, but it is a Win-Win that will create a chain reaction of alignment and other bonuses in the process.

Try it and let me know how it goes! I would love to hear from you.?

[email protected]

https://www.dhirubhai.net/in/elizabethmsouder/

?