In the business and medical world a mistake can be costly. This can be lost revenue as well as the cost of reduced customer satisfaction and loyalty. (Not to mention if the mistake hurts the patient.) Our patients and clients want our product or service to be ‘defect free’. We schedule correctly, we document correctly, we treat the right problem, and we process their insurance correctly. Lets face it, you can be an amazing practitioner but if your front desk is not providing great service and the billing is in error your patients will be dissatisfied. So how can we turn a mistake in your clinic into increased employee and team morale as well as create a raving fan with the patient the mistake was made with? Let me tell you a story…
In medicine one of the biggest pains that any practitioner goes through is dealing with the insurance company. The documentation necessary to get paid on an insurance approved procedure can be demanding and may need to be changed if denied. We have whole departments dedicated to insurance authorizations and approval of treatments.
One of the first things that we do is check the patient’s insurance benefits. We think we can treat you but there are so many different insurance rules we need to call your insurance to ‘check your benefits’. Now, just having an insurance that your clinic is in network with does not actually mean that you are in network. (Sad but oh so true.) We will use an example of say… Blue Cross Blue Shield. We are in network deep with this company. No third party administrators in this transaction. But…there is one Blue Cross Blue Shield that we cannot take and that is the self-funded UC Health version of this insurance. Long story short, while trying to assist our front desk we hired some help to call insurance companies during a busy time of year. The pre-authorization was done correctly but with one problem, we missed the UC Health insignia that should have flagged our staff that we were not credentialed to treat this patient. The second mistake, Blue Cross said we were good to go. “The patient is covered and you are authorized to treat”, they said. From here the problem continued. The billing company did not catch this problem until a few months later when we did not get paid. Our back up administrative position that checks the front desk and billing also missed the issue. Now here’s the hard part of this story. This young woman and her mother are faced with the possibility of a very large bill. They were looking at ~ 1000 dollars in medical bills that had added up over the last few months. Ouch! If you own your own business or are closely invested in your patient’s care, even in the insurance and billing portion, then you know that this is a very real scenario. Here is what Cornerstone did and here is how it created an incredible learning experience that drove our team to greater success in their positions and a client that will forever be a fan.
Once the data came in then the team met together to discuss what occurred and what could be done. As we collect the pieces of information from the group my role as the leader is to allow my team to do an ‘autopsy’ on the problem and get all the facts. Once we have a good idea of what happened then the next step is to solve the problem. In short, I need to listen. Cornerstone made a mistake and so we owned it and wrote off the balance of the patient’s bill, accepting their co-pay as their only payment. Taking responsibility for not only our mistake but also the mistake that the insurance made shocked the mother of our patient who would have been paying the bill.
The next thing that happened is that one of our front desk ladies took this mistake to heart making this comment, “I should have caught it.” While being part of the team she had not been part of the process during the mistake and really had the least association of blame. Ah, here is a team member taking on the responsibility of a mistake they did not make. Future leader? I think so.
What did we learn?
The initial problem was a leadership problem. I had created the environment for this error by adding a staff member without the necessary experience or training to do the job well. A lack of oversight then added to this problem compounded by missed opportunities from our backup ‘systems’. In short, I was to blame. Owning this and ‘doing the right thing’ alleviated the stress that the family was feeling. This is not the norm from what we have seen and experienced. This was also not my team’s fault so blaming them would have created a an ‘us versus them’ mentality limiting them from seeing a solution and causing them to cover their butts in the future. Not a great culture to work in for sure.
I also learned I had a future leader in our midst and we have been pouring into this team member, empowering her with more responsibility and taking her through our leadership training process.
Finally, what the team learned was that we as a business take responsibility and in the process of ‘doing the right thing’ we created a raving fan. Don’t believe me? You can check out her Google review on our business site. It’s one of the longer ones.
The Take Away
Don’t blame your team.
The problem is usually a process or system issue and therefore the responsibility of leadership.
As a leader you “get what you create and what you allow.”
- Dr. Henry Cloud
As a leader you need to listen. Take notes and ask questions.
Over the last few years I attend less meetings and speak less than my team in meetings. This is opposite to what I had previously done. I think it’s going well. My team seems a whole lot happier and meetings are filled with laughter.
Allow your team to come up with solutions. They may be better than yours.
You have taken the time to hire good people. They each have a unique perspective and may have a solution that you have not thought of.
Understand the value of a patient.
Their worth in repeat business and family and friend referrals is much more than the cost of solving the problem.
Grow your Team
These mistakes are teachable moments and a chance to grow your team. They are also an opportunity to look for leaders. People who not only take responsibility for their actions but also take responsibility for other people’s actions. The more leaders you have in your organization like this the better.
One thing I know…
I know that our team will not readily make this mistake again and if we do we will take responsibility and ‘do the right thing’ for our patient.
For more on this idea of learning through making mistakes (lets face it, we all make them) check out Horst Schulze, former President, Cofounder and COO of Ritz Carlton Hotels. His new book Excellence Wins has a wealth of information that any business can use to improve their service and customer/patient care.