Many years ago when I was the director of patient accounting at a particular facility, I was having a general meeting with the entire billing staff. I was going along as usual in discussing the current state of our accounts receivable progress and issues when I noticed that many of the faces seemed distracted and detached from my comments.

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A thought occurred to me, so I stopped the meeting at that point and decided to ask if there was anybody in the group that did not know what I was saying. First one hand, then another, and finally more than half of the people I had been addressing admitted that they did not understand some of my terminology. I was stunned, then realized that it was my fault not theirs.

In healthcare, just like any other business, terminology becomes exclusive to the industry. Even within the industry, I often find that there are multiple terms for the exact same thing. There are multiple terms for even an explanation of benefits. I've learned that when I go from hospital to hospital that often the terms I'm used to have been changed to suit the needs of the present personnel. Even within a facility, departments that interact with each other tend to name things differently; that's just crazy.

The communications trap is easy. New people come into a business and those who train them give them some terminology they've never before and then go about their business. How often have we verified that trainers actually understand the terminology themselves? It's easy enough to teach someone a process without them having to know the terminology. But they won't progress far without a meaning to attach to that terminology.

Many years ago I did a billing department training for a facility that had over 100 billing personnel on a billing form in use at the time. As I used some of the terminology that is common to billing (i.e. CPT-4, modifiers, ICD-9, etc), I made a point of stopping at each term and not only explaining what the terms meant but also giving examples to them. I went in with the idea that I was starting from scratch; as the classes were progressing, every once in awhile I would look at some of the faces, and I could see that spark of recognition many people get when something has finally coalesced in their mind.

In health care revenue cycle offices there's terminology used often such as: Medicare, Medicaid, compensation, no fault, authorizations, CPT-4, ICD-9, HCPCS codes, accounts receivable days, revenue, allowances and adjustments, copays and deductibles. Leaders rarely take the time to make sure their staffs understand what those things mean. And if they don't know what we're saying to them, then how can we be sure of what they're saying to patients that call up with questions?

This happens in all industries and businesses, not just health care. Education is the key factor in all things big and small. It does no good to talk about the concepts and details of one's daily duties to those who work with us and for us if we don't make sure they know what we're talking about. Leaders and managers need to take a moment to quiz their staffs to find out what they do and do not know. When you find out what they don't know, teach them or hire someone to do it for you. Never try to hide from the possibility that you may have missed something; see it as an opportunity for improvement instead. The more your staff knows, the better your office will run.

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