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March 27, 2017 Readers Write 6 Comments

What Healthcare Can Learn From My Roofer
By Phelps Jackson

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Phelps Jackson is CEO of Sirono of Berkeley, CA.

I had a leaky roof over my kitchen. In the dry season, it wasn’t a problem, but it was something I needed to take care of. I kept putting off the repairs because I dreaded the hassle of bids, estimates, and surprise expenses.

When the rainy season finally came, I started using my pots more for catching drips than for cooking. I had to do something. I looked online for the highest-rated roofing company in my area, got an estimate for repairs, and gave the go-ahead for the work.

About 30 minutes into the job, I got a call from the roofer. The wood beneath the shingles was ruined. It would add $1,200 to the repairs. When I asked why that cost wasn’t included in the initial estimate, he politely reminded me that he had warned about the possibility of additional costs.

When I asked why the price was so high, what I got was modern, high-quality customer service: on-the-spot pictures of the rotten sheathing, an email with the price breakdown, a follow-up phone call to see if I had any billing questions, and more pictures of progress as the repairs went on. Actual pictures!

In the end, I was comfortable paying the higher cost because I understood the real value of the service. Best of all, he kept me well informed throughout the whole process even though I was 1,000 miles away on a business trip.

So, if a guy standing on top of my house can offer omni-channel customer service and high-level billing support, why can’t a multimillion-dollar hospital with teams of representatives do the same?

That’s exactly what frustrated patients ask themselves every day. They don’t care about the complexity of medical claim processes. They just want to know how much they will owe and why. The reality is that 61 percent of patients find themselves surprised by out-of-pocket expenses because they were never told that pre-service estimates aren’t 100 percent accurate or more likely didn’t get an estimate in the first place.

In contrast to the customer billing support I was offered, what if three months after the repair I had gotten a roofing bill $1,200 higher than the estimate? I would have assumed that I was being ripped off, disputed the charges, and most likely left negative online reviews so others could avoid a similar experience.

It’s no different when patients receive unanticipated escalated medical bills, which is so often the case. They become suspicious of the additional charges, question their own financial liability, and delay payment or refuse to pay altogether. Even if patients are happy with their medical care and would be willing to accept additional fees, they probably assume that there was an error.

Proactive outreach to explain balance changes shows patients that they are valued and respected. It clarifies the quality of the care received, expedites payment, and inspires customer loyalty. Fifty-seven percent of patients say their medical bills are confusing.

Improving the patient billing experience is a must for every hospital. Utilizing the patient’s preferred methods of communication makes the process easier and far more patient-centered. In healthcare, as in every other industry, consumers want to interact with businesses the way they prefer, whether it is online, email, text, phone, or through the mail.

The ease of online shopping and service-oriented local businesses have raised customer service expectations and the average hospital doesn’t come close. As patient payments become increasingly critical to the revenue cycle, smart health systems will adapt and prosper. Those who don’t—won’t.



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Currently there are "6 comments" on this Article:

  1. Spot on analysis for how consumerism in healthcare is so critical for future health system success. Thank you for sharing!

  2. Did you just compare Healthcare to roofing business ? Imagine a surgeon operating with a body cut open, should they take pics and take pictures, get a price from the billing folks and send you an estimate before contuining to operate ? Try being a provider.

    • That’s not an apt comparison. Imagine instead if while the roofer was doing his thing, another random roofer dropped by took a look and hooked on his own bill. Imagine, if the roofer charged 10 times as much for supplies as you could get at home depot for the same ones. Imagine, if the roofer did the same job for your neighbor but it only cost the neighbor 1/10th as much as you. Imagine if you had no idea if the roof repair would cost $100, or $30,000. Etc., etc.

      There are a few things that could be easily fixed. Publish a list of prices and stick to them. Feel free to provide discounts to insurers, but list why the discounts are provided and on what basis. Anyone can look them up in advance. Provide itemized bill relatively quickly after the services were provided. Provide a single bill. The hospital wants to bring in additional specialists, they pay the specialists and charge you. No out of network if the hospital is in network. Don’t perform on the sly tests or get unnecessary opinions from drive-by specialists. If a foreseeable expensive treatment will be provided you should advise the patient about it. Obviously if you’re in surgery you can’t list everything that might go wrong, but you could provide sample prices for similar surgeries that didn’t involve complications (then you could show in the actual bill what was foreseen and what wasn’t). Don’t overcharge for supplies by exorbitant amounts. Etc., etc.

    • Human medicine should take a page from veterinary medicine. Veterinarians work with their clients and provide estimates BEFORE running up a bill. Veterinarians also ask their assistants to call during surgeries if something unexpected has come up. Even though you’ve taken this article out of contact, the “unreasonable expectation” you gave is actually a reality in vet med.

  3. What this piece totally ignores is that you and the provider (roofer) dealt directly with each other. Now what if you had one or more insurance companies involved, or better yet a governmental agency along with a supplemental insurance company??
    Do you really think communication would flow as easily??

    Also did you dictate to the roofer what content and format your bill should be? Did he use the proper billing codes for ‘rotten wood under layment? and which insurance company covered the tar paper, versus the nails, versus the labor??

    I am always amazed at how people outside the industry quickly blame the providers with no acknowledgement of the ‘Rube Goldberg’ payment process that has evolved over decades. If you really want a process as straight forward and easy to navigate as dealing with a roofing company I suggest you sign up for concierge medicine. But not many of us can afford that.

    • Amazingly, he’s the CEO of a patient-payment company. You’d think he’d have bothered to pop the hood on the whole billing-reimbursement thing before now.







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