The Situation:

While it established a worldwide reputation for innovation and clinical quality the Institute was also known for its poor customer service. This poor service occurred at a time when other Medical Schools and individual physician specialists (many of whom trained at the Institute) were beginning to compete with the Institute on many of their patient procedures.

The Solution:

An intense review and assessment of operations, billing practices, patient complaints and institute policies and practices was undertaken. Recommendations were made to:

Put Institute policies and procedures in writing and distribute them.

Update all CPT codes to reflect codes currently in use.

Create and distribute a list of insurance companies that have a relationship with the institute.

Create a “One Call” center to resolve patient and insurance company questions on billing.

Set a goal of dramatically lowering the current error rate on bills from its estimated 50% to 1%

Create a process whereby each patient receives financial counseling and a financial plan prior to treatment and see to it that the plan is carried out without change through the course of treatment.

Create, with physician input, a list of standard charges.
Establish an Institute-wide policy on discounts from standard charges… who can authorize discounts, for what reasons, etc.

Develop a process to reward physician referrals and to inform referring physicians of clinical results obtained.