Natasha Williams, patient account representative in Corporate Business Services’ Pre-Service Center, works with patients before their scheduled hospital visits to pre-authorize coverage and help patients understand their expenses.
Natasha Williams doesn’t see the patients she works with. In fact, her office isn’t even in the hospital.
But Williams and her fellow patient account representatives know they play a critical role in the patient experience.
“Some people are almost as concerned about how they’ll pay for their care as they are about their medical conditions,” she said. “We try to remove some of the uncertainty about costs and let them know about resources to help them pay their bills if they need assistance.”
Williams is among nearly 1,400 employees in Yale New Haven Health System’s Corporate Business Services (previously called the System Business Office) who serve all five YNHHS hospitals and outpatient locations.
A few years ago, CBS began striving for a more patient-centered approach in its functions, including Patient Access, Health Information Management and Patient Accounts/Billing.
“Our primary goal is to make the financial aspect of care as stress-free as possible for our patients,” said David Wurcel, vice president, CBS. “These improvements will also help the health system retain current patients and attract new ones in the future.”
One major shift is a new role for some Patient Finance and Admitting Services staff members. Previously, these employees met with patients at YNHHS facilities to gather their coverage and other information. While some Patient Access employees still conduct these in-person meetings, a number are now patient account representatives who staff CBS’ new Pre-Service Center.
They work with insurance companies and other payers to get patients preauthorized, then call patients before certain tests, procedures, outpatient visits and hospitalizations. They discuss with patients their coverage, deductibles and other out-of-pocket costs and, if needed, financial assistance.
Patient account representative Zoraida DeJesus recently spent hours on the phone with an insurance company to ensure it would cover a young patient’s procedure. The patient’s parents had just been switched to the insurance company, and were told it would take two weeks to authorize the procedure.
DeJesus “was truly concerned, along with us, that the delay may cause health issues for my daughter,” the mother wrote in an email to DeJesus’ manager. “Knowing that she had our backs was comforting.”
CBS has also incorporated suggestions from members of the Patient and Family Advisory Committee to make bills from YNHHS delivery networks easier to understand. CBS’ next step is to work with insurance companies to simplify their coverage notices.
Other CBS patient experience initiatives under discussion include:
