Increase Access with
 Pre-Visit Phone Calls

What happens when a patient doesn't show up or cancels an outpatient test or procedure? Open appointments must be rescheduled. And even if every lost appointment could be rescheduled at month-end, the add-ins are expensive because they result in lost staff productivity, additional staffing and associated overtime. Here's how to take an opportunity disguised as an expense problem to serve patients better while increasing access, productivity, revenue and volume: Make pre-visit phone calls.

Pre-visit phone calls reduce no-shows and late arrivals. They also improve patient perception of care, increase patient safety through an explanation of pre-procedure protocols, increase revenue, and improve access by creating greater capacity.

In fact, Mercy Health Partners in northwest Ohio has quantified the financial impact of reducing no shows as a $500 per case contribution to margin and noted a jump in patient satisfaction.

The Digestive Disease Center, led by Dr. Scott Strong at Cleveland Clinic Foundation (Cleveland, OH) used pre-visit phone calls to reduce no-shows on its 12,000 visits from an initial 12 to 15 percent to four percent, and late arrivals from a range of 11 to 14 percent to just eight percent. The center also credits implementation of the pre-calls to an increased revenue capacity of $750,000 and a jump in patient satisfaction from 47 to 60 percent.

Nurses at Hillcrest Hospital in Cleveland Clinic's eastern region also do a 100 percent case review one week prior to scheduled procedures. If there are any contraindications, the physician is notified so the procedure can be canceled or rescheduled early enough to fill the spot. The result? Several clinical saves have improved patient safety, while no-show rates have dropped to two percent.

How Pre-Visit Calls Work
A basic pre-visit phone call format:
> confirms the appointment,
> reviews instructions,
> provides directions to the facility,
> asks the patient to arrive early, and
> reaffirms the necessity of the procedure.

A "next level" pre-call also:
> explains the patien's financial obligation,
> asks the patient to arrive prepared to pay their co-pay, and
> asks the patient to write down any questions for the doctor and bring them to the    appointment. (This helps physicians run on time by avoiding last minute
   questions.)

When effective key words are used, patients perceive this explanation as a value added service provided by the hospital. It also increases revenue by ensuring early collections before the procedure.

A basic pre-call script includes:
"Hello, Mrs. Smith, this is Sally from St. Vincent Mercy Medical Center. I am calling to remind you of your MRI appointment on Wednesday, July 6th. I see Dr. Smith ordered the MRI, so he must feel it is a test you should have. Have you been to St. Vincent in the past? Do you need directions? Do you know where our MRI department is located? (If not, give directions.) If you can arrive 10 minutes early that will help us make sure the hospital runs on time for other patients. Is there anything else I can do for you today, Mrs. Smith? Thank you for choosing St. Vincent for your health care needs."

An "advanced" script also addresses co-pays:
"I see you are covered by Blue Cross-Blue Shield. Under the provisions of your 80 20 policy, there will be a co-pay on this particular procedure of 20 percent. The total cost is $1,000, so please come prepared to pay $200 when you arrive. That will take care of it so we won't need to bill you later. It will make things more convenient for you."