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    Susan Childs
    Susan Childs, FACMPE
    Coming up with instinctual solutions and employing common sense are important in any relationship; it’s no different when applied to the relationships you have with your patients.

    You use cognitive processes every day that directly affect your practice’s revenue. These exchanges involve peers, patients, physicians, vendors and payer representatives. Getting in tune with staff members and promoting a culture of self-awareness allows you to better understand, assess and maintain a rapport in your patient collections efforts that reflects confidence, accountability and growth.

    Balancing your emotional and rational brain

    In your practice, create a culture of self-awareness that allows each staff member to engage in his or her own role in the collections process with knowledge and confidence.

    But how do you tap into the brain’s ability to change? Similar to patient education, it can be transformed when you see the benefit or reward for that modification in behavior. The goal is to make your patients’ lives better.

    At L’Oréal, sales agents selected on their emotional competencies significantly outsold other salespeople because they were more in tune with their customers. On an annual basis, salespeople selected on emotional intelligence competence sold $91,000 more than other salespeople — a net increase of $2.5 million just because they were trained on EQ. Salespeople selected based on emotional competence also had 63% less turnover during the first year than those selected in a more typical way.

    The physical pathway to emotional intelligence starts at the spinal cord where senses enter and travel to the limbic system, which allows you to think rationally. Therefore, we must always first approach emotional issues. 

    Emotional intelligence

    Emotional intelligence (EQ) is made up of four core skills under two primary competencies: personal and social. These competencies compose a personality: what people remember you for and the way you are perceived. For example, I love to laugh, I’m a little stubborn and I stand up for the little guy.

    Personal competence is being aware of your emotions and managing behavior and tendencies. These skills allow you to focus on individual behavior and interpersonal interactions. They can help you to be encouraging and positive, and recognize when to ask for help. As you begin to think about the direction of your conversations and interactions, you can begin to exercise control over them.

    Social competence is composed of social awareness and relationship management. Perceiving how you come across to others and understanding moods and behaviors can allow you to manage interactions for better outcomes (For example: Collecting payment from a difficult patient).

    Consider how rationalization and emotion work together. Rationalization is what makes us different from squirrels. Intellect alone does not account for 100% of your intelligence. The remainder is your “street smarts.” Even with a quality education, being able to “read between the lines” is what gives you the complete picture. Your basic instincts can influence what you do and say and how that affects others.

    Accurately perceiving your emotions and how others perceive you provides a gap analysis of awareness. Understanding where you pay attention may help you improve your own listening.

    Perceiving emotions

    The need for EQ is heightened in this era of high-deductible health plans. When you interact with patients whose insurance does not cover a visit, you’re perceiving emotions and can relate because you want patients to have a good experience.

    This is where scripts and role-playing can help make it easier to anticipate your patients’ needs.

    Beginning with a script for all employees can help deliver a consistent message to your patients. For example, patients may notice the difference when your front office staff intensifies their collection efforts. Scripting an opening sentence for that interaction ensures each staff member delivers the same information, and from there the conversation can get specific to the patient’s situation. One way to open the conversation is to explain how much a patient is expected to pay at check-in, as opposed to sending them a statement after the visit.

    The ability to maintain an even keel and deliver a message calmly can help defuse a situation in which a patient is unruly. Understand where the patient is coming from and do not take it personally.

    Social awareness vs. relationship management

    Social awareness is what you see in others: potential, initiative, laziness, dedication or integrity, for example.

    Relationship management is what you do for others — how you help people fulfill their role. It is also the ability to understand others’ moods and behaviors and motives. You can pick up signals from others. Socially, it’s where you clarify and affirm people’s emotions, such as fear people may have when they walk into the doctor’s office, afraid of a bad diagnosis.

    One time in the practice, we had an emergency during which one patient became our primary focus. Meanwhile, another patient was quite upset because she had arrived first and saw that another patient had been taken back to a room without explanation. She then came to my office to complain. It wasn’t that she felt slighted — it was that she was going to be late for work and anxious she may lose her job. In listening to her, I had her speak with a triage nurse and she was able to return to work with a little advice.

    Only by listening to the patient did we understand her outward anxiety was more about time than her illness. The visit was free, and the trust worth millions in patient loyalty and engagement.

    Recognizing your patients’ needs

    The healthcare industry deals with emotions and processes unlike any other, and how patient needs and expectations are met can greatly affect their behavior when it comes to payments.

    Start with good manners, which relay respect and character to patients.

    A good example regarding patient collections is a receptionist who is looking down at his or her desk while asking a patient for his or her payment. Eye-to-eye contact is essential with any personal conversation, especially when you are requesting money. If a patient is upset about his or her balance or a new policy, you can show respect by offering to speak with the patient in private if he or she prefers.

    Throughout the patient experience, every staff member — administrative and clinical — plays a role in their satisfaction. If staff members are rude or disregard the patient, that could affect patient payment.

    Patient payment matters

    When employing EQ with collections, you should tailor your plan to patient needs. By doing so, they can focus on their health, improving outcomes and obtaining more beneficial contracts.

    The best example is to establish a payment plan in which payments are made within a week after the patient gets paid. Respecting the patient’s ability to pay, as well as the amount he or she can manage each month, shows respect and faith that the patient can and will remit in full.

    There are several credit-card-on-file options as well as companies that the patient can work with directly to remit payment. No one knows your practice and patients better than you, which is why EQ can be used effectively in certain situations.

    For example, one patient may be very happy setting up a credit card payment each month while another may prefer to pay you when he or she visits the office. In this case, emotional intelligence is as simple as providing options that best suit the patient’s comfort level on this sometimes delicate topic.

    To be fair to the patient, credit-card-on-hold agreements should be contingent upon the initial EOB, only with a pre-confirmed balance; for example, surgery or physical therapy benefits. Your job is to best administer each patient’s specific plan or coverage to its fullest potential. Therefore, the amount must be confirmed as a true balance due and the patient must have enough time to make an appeal.

    Emotional intelligence can also have an impact on your relationship with your payer representatives. Once you have a rapport, stay in touch and request staff in-services and education that can help your employees improve performance. By maintaining this relationship, there will be a greater chance of them responding sooner when you have a concern or issue.

    Consider how emotional intelligence can work with your revenue cycle. It may be time to revamp and redefine your goals and the roles of your staff.

    Consider patients’ emotions during collections

    • What do patients know about payment at check-in? It should be the third time they are reminded about the amount due for the visit, after first being reminded when they make their appointment and again when the appointment is confirmed. This is also a great time to inform them about a credit-card-on-file program or other financial plan offerings.
    • Do practices make it as easy as possible to check in and pay a copay? Consider a patient’s privacy when offering a kiosk or tablet to check in or make a payment. This is one of many ways to use emotional intelligence to take the fear or potential shame out of anticipated payments, while improving your revenue cycle.
    • Self-management and payment plans: Sometimes we can empathize a little too much. A possible scenario is when a patient with a large overdue balance would like to make another appointment. Consider that the patient could be terrified because of the money he or she owes. Some staff will relate to the patient owing money and not press for payment or collect as much as others may.

    Tips for EQ in communication 

    • As you converse, look someone in the eye and greet them fully. Put away any device you are carrying. The phrase, “Help me understand …” is a great starter and shows acceptance to the answer before it’s even offered. Limit side conversations and interrupting.
    • Be a part of where you are. Engage in the conversation and meeting.
    • Dress and behave professionally. Affirm other’s values and initiative. For big decisions, take time to respond. Sometimes it’s better to sleep on it before making a decision. Listen, listen, listen.
    Susan Childs

    Written By

    Susan Childs, FACMPE

    Susan Childs, FACMPE, can be reached at schilds@evohcc.com.


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