1. AAHAM WI Chapter Fall Conference
Customer Service: Handling Patient Billing Complaints Mayo Clinic Health System- Franciscan Health Care- SW WI
AAHAM WI Chapter Fall Conference
Friday, October 3, 2014

2. Point of Contact for Complaints
Most patient concerns come in through our Customer Service Call Center.
Our previous process was to escalate the call to a Supervisor line that contained a voice mailbox. The patient was instructed to leave their information, a call back time and a contact number.
Often the patient did not leave enough information on their voic to begin resolving the concern.
Some staff routed calls as soon as the patient requested a Supervisor.
We evaluated what we were defining as an escalated patient call.
A tracking tool spreadsheet was created and maintained by the unit management staff who works the escalated calls.

3. New Process We launched a new process in mid-June 2014.
Our headsets were updated to allow staff to “plug in” to other co-workers phones.
Experienced call center staff were identified to act as mentors.
Office Communicator (instant messaging) was installed on computer desktops for all Patient Account Services staff.
Scripting for staff was created.
Staff will make an offer to the caller to bring a colleague onto the call to help with a first call resolution.

4. Online Form
An online form was created for staff to complete. This eliminated the voice mailbox.
Provides standard information for account review
Allows us to track and measure results
It is used as a training tool for process improvement.
It assists with routing care-related concerns to our Patient Experience Department. 

5. Results of New Process:
July 2014:
30% drop in escalated calls versus old process
August 2014: 
52% drop in escalated calls compared to old process
September 2014:
On target for a 70% drop compared to old process

6. Monthly Totals
The Call Center averages 4,200 incoming calls per month.
Averaged 27 escalated calls per month before new process
After new process
July escalated calls
August escalated calls
Through September 14th- 3 escalated calls
Projecting 6-8 escalated calls for September 2014

7. Main Topics of Escalated Calls
EUCC vs. Urgent Care
Explain charges based on severity and utilization of resources
Review insurance benefits and coding
Agency Turnover
Patient upset their account was placed at an agency for collections
Questioning the type of service we billed (this may result in coding review)
Preventative vs. diagnostic
Lab charges performed as part of a physical but coded with a diagnosis 

8. Questions?