Sarasota Memorial Health Care System’s (SMHCS) customer service motto aims to “deliver quality patient experiences beyond discharge.” Aligned with this objective, SMHCS sought to improve quality and performance among its teams to better serve its patients, families and physicians. The hospital focused its improvement efforts in key areas of revenue cycle including Scheduling/Insurance Verification, Registration and Patient Financial Services.
SMHCS sought to accomplish the following:
- Improve the quality of staff encounters and boost service levels to patients, physicians, patient representatives, insurance companies, attorneys, and families
- Streamline the management of faxed physician notifications
- Reduce preventable denials from insurance companies
SMHCS partnered with Vyne Medical to conduct an assessment of departmental processes. Working closely together, the team identified the following areas in need of improvement:
- Boost service and performance by improving the quality of staff encounters with patients, physicians and others
- Increase accuracy and efficiency by providing immediate access to necessary records
- Streamline workflow with a paperless approach to physician notifications and confirmations
- Establish proof of verbal, fax and electronic authorization to help prevent and overturn denied claims
SMHCS and Vyne Medical worked together to identify and prioritize best practices to address these gaps which were implemented in phases and hardwired through Vyne Medical’s Trace® platform:
Recording and scoring of phone calls in Scheduling, Pre-Arrival Services, Registration, and Patient Financial Services
SMHCS’s scheduling department services nine off-site facilities and receives an average of 800 calls per day. Nine schedulers answer phone calls, with an additional nine who serve as back-up for high call volume. In the first phase of its engagement with Vyne Medical, the hospital implemented Trace Voice On-Demand™ to record these calls. Details such as demographics, patient pre-procedure guidance and facility directions are key elements often referenced in recordings.
SMHCS also began recording all inbound and outbound calls in Patient Financial Services where staff handle encounters related to billing, reconciliation and patient concerns. With management oversight, the team references Trace recordings to double-check demographic and insurance information, investigate patient complaints and deescalate concerns. Trace recordings are cross-referenced in the hospital’s billing and registration systems for easy retrieval.
To expand its ability to monitor employee performance, SMHCS implemented Trace Quality Assurance™ (TQA), the Trace quality scoring module. Patient Access leaders use TQA’s online scorecards to review and score a random sampling of recordings and chart staff performance by individual, team and key measure. The scorecards quantify qualitative factors such as tone and empathy, providing an objective measure to compare and track performance over time. SMHCS performs individual and team audits of TQA data on a monthly basis. Agents are able to see their performance trend and where it stands in comparison to the rest of the team.
Through its partnership with Vyne Medical, SMHCS has realized significant improvements in patient experience, physician and staff alignment, process improvement, and financial performance.