I want to make note of something our leadership team is engaged with in order to listen and learn about the ongoing work of our departments and organization. I received this update from Brad Willbanks, McLeod Health Legal Counsel. Working directly with the team in Reservations and Scheduling, Brad was able to listen, learn and gain a better understanding of the daily work in that department. I asked Brad for an update about his day. After speaking with him about the experience, I wanted you to hear about his impressions.
Last week I was able to work in the Reservations and Scheduling Department to observe, several of the team truly define the standards set forth in our Service Excellence expectations. I chose Reservations and Scheduling because apart from beginning at the physician’s office with a patient, most often a patient’s first exposure and experience with McLeod will come through this department. I wanted to be able to “track” a patient’s journey through the system in this manner. Scott Faulkenberry, the Director, was very accommodating and introduced me to Cathy Godbolt, a Scheduler who has been with McLeod ten years. I was able to observe and listen as Cathy interacted with patients, family members, departments here at McLeod, and physician’s offices as she coordinated the patient’s needs with the availability of services here at McLeod.
Although I sat with Cathy as she explained the process, all ten of the schedulers should be commended for their attention to our customers’ needs. Each scheduler fields approximately two hundred calls a day ranging from new appointments, re-scheduling appointments due to a patient’s change in circumstances, coordination with physician practice personnel, to collaboration with the various McLeod outpatient departments to determine if add-on appointments are feasible. The computer program that we utilize rotates the calls between the schedulers, and also alerts the staff of the availability of fellow staff members (ex. on a call, in a meeting, etc). The calls are generally fielded within three rings and the scheduler is able to track the total call time to ensure that the patient’s, department, and or physician’s office time is utilized efficiently. The caller is also given the choice to leave a message and a scheduler can call them back. The scheduled information is automatically electronically passed along to registration which prevents duplication of efforts from a registration stand-point.
I was next able to chat with Myra Allen, a McLeod employee since 2005. Mrs. Allen, like all of the schedulers I spoke with, was very attentive to detail. Myra’s focus for that day revolved around returning the voicemail messages I spoke of earlier and ensuring that all of the Medicare scheduled services meet medical necessity. In order to determine whether or not a service indeed meets the medical necessity requirements, Myra has to determine that a valid diagnosis is given with each test. Communication for clarification is often made to the physician’s office or hospital floor when orders contain vague terms such as “rule out, abnormal, or possible.” When a scheduled service does not meet government mandated requirements, this information is logged into the computer and communicated to registration that an Advance Beneficiary Notice (ABN) is needed. When a patient later presents to registration, it is explained to them that the service that they are receiving may not be covered by Medicare.
Wanda Shepherd, a McLeod employee since 2001, and with the Reservations and Scheduling Department since 2005, acts as Call Center Support and is checking the orders as they come by way of fax to ensure that they are valid. In addition to checking for the all too familiar “signature, date and time” requirements, Ms. Shepherd checks for other discrepancies as well and follows up with the physician’s offices as necessary for clarification. These orders are scanned for the departments to access when the patient’s present for their procedures.
Finally, I was able to spend time with Melanie Mastle, who has also been with McLeod since 2005. Mrs. Mastle is an insurance representative who coordinates and verifies insurance benefits for outpatient procedures. She also has a counter-part, Daisey Gray, who performs a similar service for inpatient procedures. Mrs. Mastle is constantly communicating with financial counselors, physician’s offices, patients, and McLeod departments to determine what benefits are available to the patient for the services to be performed. Although most Medicare beneficiaries’ benefits may be accessed internally through our computer system, the commercial payors often require very patient specific information such as insurance benefit numbers, National Provider Numbers (NPI’s) from the physicians’ offices, etc.
All of the team that I spoke with were very professional and courteous in their communications, whether it be the patient, an insurance representative, physician office staff, or other McLeod personnel. Our ‘customers,’ we realize, are not only the patients and their families, but also those physician offices and payor benefit organizations who we must rely upon, and they us, to give timely, accurate information to ensure a seamless, no-delay service experience for our patients.
Thank you for allowing me the opportunity to listen and learn in this department, and a special thanks to each and every person in the Reservations and Scheduling Department for the work that they do here at McLeod.
McLeod Health Legal Counsel