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BBT Ep. 9: Hiring A Medical Scheduler

June 06, 202313 min read

In this episode we cover how to track performance when hiring a medical scheduler.

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 Welcome to the Better Billing Today podcast, where we talk to owners and operators of small clinics and practices, helping them with revenue cycle management best practices. On this show, we're discussing how to improve the patient financial experience, streamline your operations, and increase your cash flow.

I'm your host, Adam Welchel, and today we have Chris on the controls.

Hello. Hello. You can see all of our episodes and find us on your favorite podcast platform at Send in your questions, stories, and more at Back to you, Adam.

Thanks Chris. On today's episode, we're discussing the topic of outsourcing your revenue cycle management, engaging with third parties and billing services like Spark Billing. But there's a new trend that's creeping its way across the US where patients are at the negative financial experience side of the equation when these third parties or even the providers themselves are offering medical credit cards when the patient could actually qualify for government assistance or even their private insurance.

We've said on this show before that the insurance companies can make this so unbearably ridiculous and there's so much red tape and there's so many barriers and obstacles to jump through. There's even insurance companies that have algorithms that will just deny claims without even looking at them. So a link to that article that we shared a few weeks ago is gonna be in the show notes as well, but, when the patient could qualify for insurance or Medicare or Medicaid, and the third party is not even willing to put the claim through the process and give the patient a medical credit card, what's happening is the patient is not fully informed about the consequences of one single late payment.

For example, Care Credit, I think it was 2013, had to give back $34 million to patients who were deceived into getting a card because they were not fully educated on what would happen if they missed or they were late on one payment. And these deferred interest payment cards, the truth is the patient, if they missed one, they have to pay the, in the interest from day one!

And you might be 18 months into a 24 month payoff and if you have any interruption in your cash flow as a patient, you have to pay 18 months of backdated interest on this transaction. That can be a devastating experience for them, especially when they could have qualified for insurance and the providers already been paid by the credit card company.

Now, traditionally, these medical credit cards have been used for elective procedures and dental procedures and things that are not usually routine, but they're like, they're elective. But now because of the difficulty that providers have getting paid from insurance companies, the cost of administration to code, to bill, to batch, to submit, to review, to handle denials and follow up and appeals the cost of getting paid is just skyrocketing.

And revenue managers are coming up with the best ways that they think to get the provider paid. However, it's coming at a cost that is going to really rock the healthcare industry. And this article from the Prospect, the American Prospect came out last week and the link to this article is in the show notes.

But there's a lot going on in this space because there are consumer protection acts that are actually being skirted because of this loophole with medical credit cards. There's even a firm in New York that has helped 30,000 New Yorkers save them about 40 million in healthcare costs because this, there's a huge increase in medical debt, 64% for this firm over the last two years from 2018 to 2020.

But the problem is it really comes at the cost of the patient. They're not at the center of the patient Financial experience money is, and these insurance companies and their practices and what they're requiring their providers to do is causing some desperation it seems in the industry to just abdicate financial responsibility to the patient, make them figure it out, and that's really an injustice. We have the No Surprises Act, which was supposed to help the providers, supposed to help the patients get transparency from the providers, good faith estimates, out of network cost, things like that.

But when you add this this financial practice in the background that says we're just gonna skip the insurance issue and make you finance this when the patient could have qualified for coverage or received benefits from the insurance company or Medicaid or Medicare, that just is, it's very heartbreaking because they're at a financial position. They're put into a financial position they shouldn't even be in to begin with.

So you're saying that patients who could have qualified for their insurance covering the procedure, they're not even being given or that route they're being told to go down another way and it's causing them even more harm?

Yeah. You have a provider that's trusting a revenue management company, like an outsourced billing service to take the claim and submit it through the proper channels or the traditional channels, and instead the revenue cycle management company is contacting the patient and getting them to finance this service. Now, this is not necessarily a complete dig on revenue cycle management. The administration of getting paid for a provider is costly. It's time consuming, and there's a whole lot of work to do; there's a lot of people to hold accountable in this revenue cycle that we're talking about. And it's not to say that revenue cycle management companies like R 1, are all doing this and that outsourcing is bad.

I can't say that, we are the outsourced solution for some of our doctors and we don't have this practice in place. We put the claims through the traditional channels and we get the benefits in a normal way. But there may be cases where the patient portion of this bill could be financed or put on a medical credit card, but that should be at the very end of the cycle, not at the beginning.

And I think that's where the abuse is being highlighted, is that the patient's not given a fair chance to get these bills covered by their insurance company or the government.

And shouldn't it be made clear to the patient what option they have to them?

The article states that if the provider themselves or the staff from that provider are giving these medical credit card options to the patient, there's already this embedded trust, I trusted you with my health my wellness and my journey to health, and now you're offering me a credit card. I'm assuming that if you have the Hippocratic Oath that, you know do no harm, I'm assuming that you're giving me a financial resource that I didn't have access to and I have it now because I've partnered with you on my Health Journey and there's no adverse consequences to, oh, I'm late this month, or I missed a payment, or I lost a job.

And the article states that those with the lowest credit scores are actually hurting the most because they have low credit and they sometimes miss a payment. And so now they have this huge amount of interest to catch up on. And the cost of that procedure is nowhere near what they expected it to be which again, in light of the no surprises act, that's a big surprise when you're not disclosing the risk of financial credit cards and you're putting this burden on the patient.

So yes, you're spacing it out, but still, if they are not aware of the risks of what could happen to them financially by missing one single payment That is not, in my opinion, doing no harm! Withholding information that is very costly to the patient is definitely not doing no harm.

And even though the revenue management companies involved, the responsibility is always gonna come back to the provider. Who are you partnering with and who do you trust to help your patients? What have you discussed and what have you agreed to that the revenue management company will do for you and your patient?

Because at the end of the day, you're responsible for this whole entire cycle. And sometimes there's a lot of partners in the revenue cycle. You have medical scheduling, you've got patient verification, you've got coding, transcribing, you have billing, and then claims and collections and patient AR and then there's actually the bookkeeping of this whole process.

So there's a lot of pieces that different players are involved in, but ultimately the provider and the standards that they're expecting these partners to uphold, it's gonna come back to them. And if they're not writing into their agreements with these vendors that you will do this in these cases, you will only offer these options in these cases, and then we can audit you on these practices if they're not requiring these things to be in place. It's the provider's responsibility to usher that patient through a financial experience that's on brand and on policy.

So again, the link to this article is in the show notes, and I did touch on one point of this revenue cycle and that is the scheduler. And if you're an owner operator of a small clinic or practice and you're thinking I don't have any intention of outsourcing my billing or any aspect of the revenue cycle, that's why this is perfect for you because we've put together a medical scheduler, best practices.

Actually this resource, there's, it's in two parts. The first resource is how to hire and find a great medical scheduler. This is the person that's going to be one of the first points of contact for the patient when they're interacting with your brand, with your, the experience you want them to have. And is this person upbeat, bright and bubbly and helpful? Do they have customer service in their blood and are they interested in helping the patient even if they can't book an appointment today or tomorrow?

What are you giving this medical scheduler? What resources do they have to make sure the patient feels acknowledged, cared for, that they matter and that they are really wanting to help them? The medical scheduler, even if their calendar is completely full, is not the role that you want to have them kick up their feet and just relax and wait for the phone calls to come in.

This medical scheduler can actually make outbound phone calls, follow up and see how patients are doing, see if they got every, all the care that they really needed. And so these are just some of the points that I'm highlighting in our medical scheduler series where we're showing you what attributes to look for in the medical scheduler, how to find them, what interview questions to give them and see how they respond. And we're even giving you what they should say in the response or something close to it because we want you to attract and find and train the best people on your team to go, we had an episode on this, to go from a seven to an eight.

How to make your clinic or your practice go from a seven to an eight? And sometimes it's just one person at a time increasing the quality of the communication between them and the patient and improving the patient financial experience from the first time they get on the phone.

So open up the medical scheduler, download this in the link today. Look at the resources that you can use to find, attract, and develop your team starting with the medical scheduler. They're the first person that the patient's gonna talk to.

And we're actually coming out with the medical scheduler success plan and this is the document that will guide you from day one when they get hired to a three month onboarding plan, things you're going to expect them to learn how to do to make sure the patient financial experience is at the center of everything you're doing in your clinic or your practice. So be on the lookout for that. If you want the link to our medical scheduler hiring guide, it's in the show notes or better billing if you just wanna download it straight from the website.

So there's so many chapters in this particular guide. I'm just gonna pick one on tracking performance, assuming you've made it through the interview, the hiring process, and now they are actively in the role, how do you know your medical scheduler is performing?

You're a busy doctor, you don't have time to be there; you can't actually be there all of the time watching them. But there are some things you can look for if you're using an online phone system like RingCentral, a HIPAA compliant phone system. You can track average call handling time appointment conversion rate, how many calls did you get in? How many appointments did you schedule? What are the reasons for, low numbers?

Just looking and letting them know that you are looking because you do want them to help patients get the right care that they need as soon as possible.

Another thing is patient satisfaction. Again, if you're not getting inbound phone calls. You should be expecting your scheduler to make outbound phone calls and get feedback from your patients. Just name, give it a score from one to 10. Simple things like that. This can be done on paper. You don't need fancy software to, to care about a patient.

You can just be interested in how's the side effects? Do you need to do another follow up visit? Are things going well? Have you had any reactions? Like, just being helpful! So when calls are not coming in, the patient scheduler is making outbound phone calls, following up with the patient and letting them know that you and the entire practice that you care about them and you want them to make progress on their health and wellness journey.

So that's just one section of a chapter. There's a lot of resources in here, and if you have any questions about what you find in this chapter and you wanna discuss it more, feel free to email us at, and on that website you'll find our links to the podcast, the videos, the audios, all of the resources, and we are on every major podcasting platform so that you can listen to this show on your favorite platform.

Thank you for joining us. My name is Adam Welchel, and this is Better Billing Today.


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