2G-The Cost of Alienating a Patientaapcperfect.s3.amazonaws.com/a3c7c3fe-6fa1-4d67-8534-a3c...13 Accessing Thinking "The initial act of answering seemingly harmless questions is enough

1

h i h C fh i h C fThe High Costs of The High Costs of Alienating A Alienating A

PatientPatient

www.keybridgemed.com

All Rights Reserved


All Rights Reserved

4 CostsFuture Business

Malpractice Suits Lower Reimbursementp


All Rights Reserved

Negative Publicity

2

Poll: Patient’s Lifetime Value?

• $50,000.00

• $100,000.00

• $500,000.00

• $1,000,000.00


All Rights Reserved

$1,000,000.00

Hospital Physician

Average Age(U.S. 2010) 36.8

Average Years of Life Remaining @ 37 Years of Age (2006)

42

Annual per CapitaAnnual per Capita Expenditure(2011 Projected)

$8666 $3206 $2166

Average Projected Lifetime Expenditure @ Age 37

$1,369,663 $506,775 $342,416

Average U.S. Household Size

3.14


All Rights Reserved

ProjectedExpenditure per Household

$4,300,742

3

Poll: How many malpractice suits?

• NoneNone

• 1 ‐ 3

• 3 ‐ 5

• 5+


All Rights Reserved

• 5+

Higher Risk of Malpractice Suits

Risk of a AverageRisk of a malpractice suit is 19% with a poor satisfaction rating!

Average cost to defend a

malpractice suit is

$22,000.00.


All Rights Reserved

4

Reimbursement Reduction

Impact of Value‐Based Purchasing reductions in payments fromMedicarepayments from Medicare could be as much as 2%.

Private payers and Medicaid programs expected to follow suit.

Physicians expected to be


All Rights Reserved

y pnext.

Poll: How many will they tell?

• 33

• 7

• 11

• 20


All Rights Reserved

• 20

5

Free (Bad) PublicityUnhappy consumers tell 11 people about their bad experience.

That number can explode if other media pick it up!


All Rights Reserved

Poll: Receive complaints?

• Yes

• No


All Rights Reserved

6

Strong Links

Billing & Collection

A negative opinion of the financial process increases dissatisfaction with the clinical


All Rights Reserved

Patient Satisfactionexperience 40% of the time.

What should I do?

• Step 1: Measure patient satisfaction with both clinical andbusiness processes.

• Step 2: Examine every aspect of the patient billing process.

• Step 3: Train every non‐clinical staff member on customer service.

• Step 4: Assess any outsourced business and its process


All Rights Reserved

business and its process.

• Step 5: Choose the right revenue collections partner.

7

Heed Mark Twain’s Dictum:

“The difference between the almost right word and the right


All Rights Reserved

word is really a large matter – it’s the difference between the lightning bug and the lightning.”

5%5% 95%95%


All Rights Reserved

8

The brain is a The brain is a patternpattern‐‐recognition recognition

tool.tool.


All Rights Reserved

ConsciousNon‐

Conscious

Resistance indicates the lack of rapport

NONO


All Rights Reserved

9

Rapport begins with Sensory Acuity.


All Rights Reserved

Sensory Mirroring

Example:

They say, “My employment picturedoesn’t look too good right now.”

Sensory mirror, “Oh, I see. Do you h k ll l ?”


All Rights Reserved

think it will clear up soon?”

10

FramingFraming

Example:

“This may just be an oversight.”


All Rights Reserved

Embedded Commands.Commands.

Example:

“You like me, are probably enjoying

the spring weather we are


All Rights Reserved

having.

11

Ambiguity

Example:

No & Know


All Rights Reserved

Tag Questions

Example:

“You’re beginning to see how easy and natural these

techniques are to


All Rights Reserved

techniques are to use, right?

12

ConversationalConversational Postulates

Example:

“Can you pass the salt?”


All Rights Reserved

salt?”

Double Binds

Example:

“Would you like to pay with cash, or use a check or credit card today? I don’t know which

would be better for you.”


All Rights Reserved

13

Accessing Thinking

"The initial act of answering seemingly harmless questions is enough "The initial act of answering seemingly harmless questions is enough to produce a state of mindlessness which increases the odds of to produce a state of mindlessness which increases the odds of complying with a larger target request," the authors conclude.complying with a larger target request," the authors conclude.

[Bob M[BobM FennisFennis LoesLoes Janssen and Kathleen DJanssen and Kathleen D VohsVohs Acts ofActs of


All Rights Reserved

[Bob M. [Bob M. FennisFennis, , LoesLoes Janssen, and Kathleen D. Janssen, and Kathleen D. VohsVohs. Acts of . Acts of Benevolence: A Limited‐Resource Account of Compliance with Benevolence: A Limited‐Resource Account of Compliance with Charitable Requests. Journal of Consumer Research, April 2009 DOI: Charitable Requests. Journal of Consumer Research, April 2009 DOI: 10.1086/593291]10.1086/593291]

Summary


All Rights Reserved

14

“Small changes in the way that requests are made can often lead q

to startling big results!”

-The Authors of “Yes! 50 Scientifically Proven Ways To Be Persuasive”


All Rights Reserved

Ways To Be Persuasive

Sorting “can’t pays” & “don’t owes”

Is it okay if I ask, are you feeling that you don’t owe this bill or that you just don’t see that you have a way to pay the bill right now?

?


All Rights Reserved

15




All Rights Reserved

Is it okay if I ask




All Rights Reserved

feeling see

16



have a way


All Rights Reserved

have a way

pay bill now

How to Build a Response

“I just got laid off.” I will have money in the future.

Fear

I won’t have money in the future.


All Rights Reserved

Willing/Not Able

17

“I just got laid off.”

“That’s OK I hear

Say This Not That

That s OK, I hear that a lot these days. When did you get laid off? When will you start to receive unemployment?

Do you see yourself working soon?”

“OH, I’m sorry, we’ll call you later.”


All Rights Reserved

“I didn’t bring my checkbook.”

•What is the problem?


Willing/Not Able

•What is the patient feeling?


Resistance to paying now. •What does the

patient believe?•What does the patient believe?

I can pay this later.

• What can I cause the patient to think?

•What can I cause the patient to think?

I have other means of paying now. • How can I build

rapport and avoid reflexes?

• How can I build rapport and avoid reflexes?

Use language techniques.


All Rights Reserved


All Rights Reserved

18

“I didn’t bring my checkbook.”

“That’s OK, people do that all the time They

Say This Not That

that all the time. They just call us when they get home and give us

their checking information or credit card over the phone. Is that how you want

to handle this?”

“OK, we’ll send you a bill.”.


All Rights Reserved

“My insurance should cover this.”



Able/Not Willing



Resistance to overpaying. •What does the


Someone else owes this bill.



This is my responsibility. • How can I build





All Rights Reserved


All Rights Reserved

19

“My insurance should cover this.”

“I’m sure you don’t

Say This Not That

I m sure you don t want to pay if your insurance covers this,

right? And your insurance won’t

cover your co‐pay. How would you like to take care of that

today?”

“We’ve billed your insurance already.”


All Rights Reserved

“Just send me a bill.”



Willing/Not Able



Resistance to paying now.

• What does the patient believe?

•What does the patient believe?

The longer I keep my money, the better.



It’s better to pay it now.



Use language

techniques.


All Rights Reserved


All Rights Reserved

20

“Just send me a bill.”

“I know you’d rather d bill

Say This Not That

we send you a bill, everyone would, and I also know that you

probably hate getting stacks of bills in the mail. Wouldn’t you

really like to avoid that and take care of this

now?”

“OK”


All Rights Reserved

“My spouse pays our bills.”



Able/Not Willing

• What is the patient feeling?


Resistance to paying now.



The longer I keep my money, the better.



It’s better to pay it now.





All Rights Reserved


All Rights Reserved

21

“My spouse pays our bills.”

Say This Not That

“Is your spouse with you? If your spouse was with you, they would pay it now, right? Is there some way I can reach your spouse right now?”

“OK”


All Rights Reserved

“I had no idea I had a co‐pay for the Emergency Room.”



Able/Not Willing



Resistance to paying if they don’t owe.



Someone else will pay this.



This is my responsibility.





All Rights Reserved


All Rights Reserved

22

“I had no idea I had a copay for the Emergency Room.”

“I’m sure you don’t

Say This Not That

I m sure you don t want to pay if your insurance covers this,

right? And your insurance won’t

cover your co‐pay. How would you like to take care of that

today?”

“We’ve billed your insurance already.”


All Rights Reserved

“The doctor sent me –I should not have to pay.”



Able/Not Willing





The y don’t have to pay.



It is my responsibility. • How can I build





All Rights Reserved


All Rights Reserved

23

“The doctor sent me –I should not have to pay.”

“ h h

Say This Not That

“I see, when the doctor sends you here it is to receive services which he

can’t provide, just like if he sends you to a pharmacy to get a prescription, right?”

“That doesn’t mean you don’t have to

pay.”


All Rights Reserved

“I was here the other day –why do I have to pay again?”



Able/Not Willing





This should be “no charge”.



This is my responsibility. • How can I build





All Rights Reserved


All Rights Reserved

24

“I was here the other day –why do I have to pay again?”why do I have to pay again?

Say This Not That

“Because each time you visit you receive additional services. Today’s charges are for those additional

services ”


All Rights Reserved

services.

“I thought it was free to come to the Emergency Room.”



Able/Not Willing



Resistance to overpaying.



Emergency Room services are free.



Emergency Room services are not free.





All Rights Reserved


All Rights Reserved

25

“I thought it was free to come to the Emergency Room.”

Say This Not That

“ER services might be free if you qualify for charity care. Would you like to apply for

charity care or financial assistance?”

“I’m sorry. They’re not free.”


All Rights Reserved

“If I don’t pay does that mean you will not see me?”



Able/Not Willing



Fight reflex.• What does the patient believe?


I have a right to ER service.



Service will be provided, but there is

a charge. • How can I build rapport and avoid reflexes?




All Rights Reserved


All Rights Reserved

26

“If I don’t pay does that mean you will not see me?”

“We will not refuse

Say This Not That

We will not refuse service to anyone needing emergency treatment. However, we ask that you make arrangements to pay

your financial responsibility prior to

leaving the ER.”

“No”


All Rights Reserved

How to Build a Response

“Can I make payments?”

Time, not amount.

Resistance to paying in full now

The smaller the payment, the better.


All Rights Reserved

Willing/Not Able

27


Say This Not That“How much would you like to pay?”

“How much are you short of the balance?How much time will you need to pay the

balance?”


All Rights Reserved



All Rights Reserved

28

http://www.keybridgemed.com/resources‐thought‐leadership

Contact: David MorriseyDirector of DevelopmentK B id M di l R M t


All Rights Reserved

KeyBridge Medical Revenue Management1‐800‐627‐7432 x [email protected]

Suggested Reading


All Rights Reserved

Documents

2G-The Cost of Alienating a Patientaapcperfect.s3.amazonaws.com/a3c7c3fe-6fa1-4d67-8534-a3c...13 Accessing Thinking "The initial act of answering seemingly harmless questions is enough