Tell Me Now: A focus on Customer Service
Part 6
     


I would like to first thank you for the continued feedback on the “Tell Me Now” column; explaining how the customer service initiative is giving patients a voice and improving their experience at Granville Medical Center.

In past columns we’ve discussed the changing landscape of health care. How rising costs affect the care you receive and how we, as a hospital, do business. The process of navigating the delivery of care system has become more complicated.

One issue we continue to receive comments on really focuses on the confusing process of copays and deductibles. As a point of reference, copays are a flat fee you pay toward services. This is your initial payment for service, no matter the reason for your visit. Deductibles are the portion of your medical expenses not covered by a copay and you are responsible for 100%, until you reach your deductible limit. It’s much like your car insurance. When medical expenses occur, you pay your deductible and then insurance kicks in to help pay the remainder of the bill.
To be sure, deductibles are rising. In fact, in many cases the increase in level of deductable has risen by thousands of dollars over a relatively short amount of time. Today the average deductible is between $2,500 and $5,000 while 2 years ago, deductibles averaged $500 to $1,000. There has been an across the board shift of fiscal responsibility in the health care insurance industry.

In today’s health care environment, all insurance providers, including private/commercial insurance companies, Medicare and Medicaid, are requiring folks to cover more of the upfront costs of their hospital stay or outpatient procedures. Sometimes, this disrupts the delivery of care because patients are caught off guard by the financial obligations set by their insurance company. As I’ve had the opportunity to speak with a number of groups in our community, people are letting me know they have questions and need answers on how best to manage their upfront health care costs.

First, let me address the elephant in the room. Some insurance plans require a higher deductible than others. Sometimes changes in plan coverage have occurred that patients may not be aware of, or perhaps they’ve switched to an insurance carrier that requires a higher out of pocket amount. It’s not uncommon for our registration staff to identify plans requiring $5,000 or higher deductibles. Patients should carefully review insurance plans before agreeing to a contract. For example, many of the Healthcare Marketplace plans with higher deductibles and lower copays might benefit an active family with lots of medical office visits but fewer hospital stays and procedures. Finding the right mix of copays and deductibles for you and your financial situation is important.

You see, Granville Health System is contractually bound by a patient’s insurance company to collect all deductibles and copays. In addition, we are contractually prohibited from waiving any portion of these fees. So, it’s understandable that patients may find themselves in a difficult position if they are not aware of the insurance plan’s financial obligation. It can delay service and result is a less-than-desirable patient experience.

After many years in health care, I can share this with you; we have some of the most knowledgeable and experienced staff working in our registration areas of our hospital. These folks have developed an excellent program: Straight To A Room (STAR). The STAR program helps patients smoothly complete the registration process and successfully navigate through insurance plan requirements such as deductibles, pre-approvals and scheduling. By working with you and your physician’s office, our staff can register you as a STAR Patient before your procedure. Our registration staff will contact you ahead of time to initiate the STAR process.
So, what is the benefit to being a STAR Patient? On the day you receive care, there is no waiting or financial consultation. STAR patients go straight to a room. There are no billing surprises and there is no delay in service. This ultimately provides a better patient experience.
Today’s health care environment is complicated. What I’ve shared with our community, and what I share with you, is that Granville Health System has heard your frustration in managing insurance coverage costs. Programs like STAR can help mitigate a number of insurance roadblocks and delays in registration. The process also helps educate patients in terms of financial responsibilities set by their insurance plans.

There are other valuable resources available through Granville Health System. Our Patient Financial Services team can help qualified patients establish payment plans. If you do not have health care insurance, our GHS Certified Application Counselors are on duty during ACA Open Enrollment to help navigate plans offered through the Health Insurance Marketplace. Again, since insurance companies establish deductible levels, patients should ask questions when they are purchasing insurance. The best plan for a family is not necessarily the least expensive plan. This reasoning applies for plans purchased through the Health Insurance Marketplace as well as private insurance offered through an employer.

I’d like to again thank our community and the readers of this newspaper for your support of the “Tell Me Now” program. Thank you for the feedback you’ve given me as this campaign moves forward. I would ask for your continued comments on customer service and how we can earn a 10 on your next visit. You can contact me directly by email at lisley@granvillemedical.com or visit ghsHospital.org/TellMeNow for more information.