Some years ago I had to "pull rank" on someone who was working in a physician's billing office. Someone kept calling my mother and telling her that she had to contact an insurance carrier on the physician's behalf because the insurance carrier was incorrectly paying on my mother's account. The major problem was that Mom had told them not to bill this particular insurance but they did it anyway. Her account was being overpaid; the issue wasn't Mom's, but theirs.

Mom got frustrated after the second call and called me. I was irritated because Mom had difficulties with the same office regarding a previous bill and I'd had to contact them to resolve the issue... more than once. So I wasn't feeling a lot of love for any of them. I got the phone number from Mom and gave these people a call.

The woman on the phone started to tell me the same thing she was telling my mother, but at one point she slipped and said something I knew was incorrect. I stopped her immediately, told her what I did, told her how long I'd been doing it, and proceeded to tell her that she was incorrect in her information and process.

She was wrong on a lot of things, and I knew she was parroting what she'd heard. I wasn't mad, but I was forceful. I told her my mother wasn't calling anyone because it wasn't her issue. If her account was being underpaid, that's one thing, but they'd have just sent her a bill for the balance. Mom had told her office what not to do, they were doing it anyway, and it was their problem to correct.

I asked if she understood where I was coming from. She said yes, but that Mom's accounts would continue being messed up. I reiterated that their accounts being messed up was their issue, not my mother's, and no one had better call her again on this matter; they never did.

Once I was talking to a friend of mine in another state. She had to do something similar for her mother, only it was for a medical procedure. Her mother had received a phone call saying she had to go to the hospital for some kind of scan. They didn't tell her mother what kind of scan, or what the scan was for. My friend called the physician's office multiple times and left a message, but no one ever called her back.

A day before the scan, my friend finally got through to someone and pretty much lambasted them. She asked why her mother was going for a scan, and the person basically started reading words from the medical record. My friend was a medical biller but didn't have a grasp on medical jargon, so she asked the woman to break down the technical jargon and tell her what it meant in layman's terms. When the woman told her my friend asked why no one had told her mother this; the woman said she didn't know.

The next day, my friend and her mother showed up at the hospital for the scan. When the woman came out to do the scan, my friend asked her if anyone from the hospital had tried to call her mother about the scan. The woman said yes, to schedule the scan. She asked if anyone had told her mother what the scan was for; the woman said she didn't know.

It turns out that no one at either place had ever told my friend's mother why she was having the scan. My friend told the woman to tell her mother what the scan was for, and she proceeded to read from the medical record; seems to be a pattern here. My friend stopped her and told her to break it down into terms most people would know, which she did. When she was finished, my friend asked her mother if she had ever been told she had a particular problem; her mother said no.

She then asked the woman why no one had ever told her mother about this issue, and why they hadn't sent her to a cardiologist. The woman said the doctor wanted to monitor things instead; the doctor wasn't a heart specialist. My friend basically told people off and asked about lab tests and other things in the medical record. She said no one had ever informed her or her mother of any results from any tests, and how dare they play with her mother's life like that. Then she sent her mother for the test, which was pretty crucial based on the new information.

This sounds like something that only happened in previous years, but it's not. Today I went to see my own doctor, who's part of a large physician practice. While I was sitting in the waiting area, I listened while one patient was asking the registration clerk why she was having a certain procedure, and having another patient being asked if her arm was broken or fractured. I thought both of these were strange until I thought about the reason I was there in the first place. I was having a follow up visit after a physical, but I'd never thought to ask what was being followed up on and I was never told either (turns out it was something I didn't even have a complaint about but mentioned in passing that the doctor had taken more seriously than it needed to be).

Medical people have different thoughts on what customer service is all about. Most of them feel if they're nice to their patients and can get to them relatively close to when they're supposed to see them, based on the time of the appointment, that they're giving great customer service. This pretty much means there's a lot of customer service failure going on all the time. So many people gripe about transparency when it comes to pricing that they forget about the lack of transparency when it comes to medical condition here and there.

If medical condition isn't an issue then revenue cycle issues are still fairly problematic. I've had to tell the administrative services of my mother's podiatrist multiple times that when they bill Tricare they need to submit explanations of benefits for her bills to get paid; why is this such a hard concept, especially since she's not the only former military spouse they treat?

I'll give credit where it's due; these days customer service people are nicer than they used to be. Either that or maybe they're just nice to me. 🙂 Nice can only get you so far when patients have needs that aren't being addressed.

I implore more medical facilities to evaluate their customer service policies and procedures to make sure they're not only friendly but that their patients are getting the best information about their medical issues. Don't assume all is okay; make sure it is.