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UNCHCS monitors initiative progress

Patient Access Weekly Advisor, January 2, 2008

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Over the past year, officials at UNCHCS thoroughly examined every financial process. They considered customer service, financial viability, and staff burden, and they drew up realistic changes that would keep each of the system's priority interests in mind.

UNCHCS is monitoring progress but also emphasizing to staff members the following key principles that evolved from the process redesigns:

• Exhaust all third-party options to cover the cost of care. At the end of fiscal year 2006, UNCHCS had a staggering $290 million bottled up in accounts receivable. Now, prompt payments are the order of the day.

  "Our charity care program is only available when all other options are exhausted. We had to clarify that," says Karen McCall, UNCHCS' vice president of public affairs and marketing "Things weren't consistent in our system. So much of this process was just being diligent to get consistency throughout the system."

• Ensure access to financial counselors. In 2006, UNCHCS expanded eligibility requirements for its charity care program. However, at the time, it didn't bulk up its staff to accommodate the additional business.

  "Without sufficient staff, we really weren't able to keep our promise," says McCall. So UNCHCS added five financial counselors to the staff. The organization also uses roving financial counselors, who bounce around from clinic to clinic, going wherever there is a need. Clerical staff members order a roving financial counselor through a program on UNCHCS' Web site.

• Ensure that billing is accurate and easy to read. This is probably the biggest challenge for UNCHCS. "I think we'll keep working on this the rest of our lives," McCall says. "Hospital and physician billing is so complex that this will always be a challenge."

  UNCHCS relies on customer focus groups to shape new ideas to simplify the bills. "People are still looking for a MasterCard bill, and it's just not that easy," says McCall. "I think the industry as a whole still has a long way to go."

• Ensure that patients understand their obligation to pay. One ongoing challenge is the fact that hospital-based clinics have an opportunity to charge a facility fee in addition to the physician charge. "We've really given a great deal of effort to make sure the patient doesn't find this out as a surprise," McCall says. "We send letters to them ahead of time, and we include a notice on the appointment slips to alert them to this."

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