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Jeff Lin
Host of Payment Matters
Payment Matters is a monthly radio show focusing on real issues happening in healthcare payments. Jeff chats with industry experts and thought leaders to bring fresh perspectives on how providers, payers and consumers are all tackling the evolving healthcare payments market. Join the conversation on Twitter with #PaymentMatters.
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On this episode of Payment Matters, Jeff is joined by Kevin Pawl and David Gates of Boston Children’s Hospital. Jeff, Kevin and David discuss how Boston Children’s Hospital improved the payments experience for guarantors and staff.

Listen now, or read an excerpt of the episode below.

Jeff Lin: Do you experience any different challenges from a patient or a demographic perspective that’s unique to a children’s hospital versus a non-children’s hospital?

Kevin Pawl: Yeah, I think so. I have two kids myself and whether it’s something that’s a primary or secondary diagnosis – an ankle sprain or wisdom teeth versus a heart condition or something to do with a child’s brain – I think that you need different care and services for those different types of patients. Parents will do anything for their kids. They want more choice when it comes to the simple things like ankle sprains and wisdom teeth. They’re willing to tolerate a bit more of the disparate systems that we’re trying to change when it comes to a really sick kid, but we want them to have a great experience, rather than trying to put up with the siloed systems that we have in healthcare.

David Gates: With the pediatric population, you can imagine we have a lot of families who come in with young kids and often times a single guardian. For example, if a single mother comes into the office and has to go to the kiosk and check in, where does she put everything? Where does she put her purse or backpack? How does she keep track of the kids while interacting with the kiosk? We have to keep those things in mind when we’re going to implement any type of technology because we don’t want to make it increasingly difficult for the family. We want to make it a benefit to the family.

Kevin: When they cross our threshold, we are hoping that the business side of healthcare is minimized so that we can really focus on the care of that entire family unit. I think a lot of the technology advances that David and I are excited to be involved in, do make it much easier for families. I know I just recently e-checked in for one of my kid’s visits and my wife didn’t then have to find and pull that flexible spending card out of her wallet. She was already checked in and the payment was processed seamlessly, which was great.

Jeff: It sounds like you went through some transformations around the payment collections.

Kevin: I think a lot of our staff feel uncomfortable asking families for money. Therefore, part of it was training and education as well as having their supervisors support them. We also find that kiosks are one of our best co-pay collectors.

David: When we went live with kiosks, everyone was very concerned about patients being presented large balances for payments. We didn’t have any expectation that those folks would be paying the large payments right off the bat, but on day one we ended up receiving a $5,000 payment from a family. Interestingly enough, the payment wasn’t actually for the patient that was checking in. The user at the kiosk was the guarantor for the patient, and was also able to look across the other patients that she was the guarantor for, and so it was actually the patient’s sister’s bill that she was able to pay right there. Now we have families who want to pay their past balances at the kiosk rather than waiting for the bills that come in the mail.

Jeff: Can you talk about your cashless initiative?

David: We used to collect cash at the front desk areas and found that it was a real problem. More and more places don’t use cash around Massachusetts. We were struggling with end of day reconciliation and collecting copays and were only collecting 40% of copays. We ended up doing a focus group with area supervisors and some front desk staff to talk about how we can increase the copay collection rate, and we quickly realized the root of the problem was cash.

Kevin: I remember that design session where we were talking about the cash drawer, these bags with keys on them and people carrying these bags all over the enterprise with cash. Some even admitting that they would have checks and cash under their keyboards, having to stay late to close out. What was amazing to me is that we made the end users comfortable enough that they told us all of this. Some of it, you could argue, would be embarrassing. Why is the operation out of control around cash? Every time we looked at things we could do to improve the process, cash was a bit of a stumbling block. At one point we said, “Why don’t we just get rid of the cash?” Today, we don’t have zero cash system. If families do want to pay with cash, we do have a cashier in a central location. However, we’ve eliminated 97% of cash in our organization.

About the Host

Jeff Lin is Senior Vice President of Product Management at InstaMed. As head of Product Management, Jeff leads the ongoing product innovation of InstaMed’s healthcare payment solutions. This includes the exploration, evolution and execution of InstaMed products that further simplify the healthcare payments process. Before joining InstaMed, Jeff was an executive at Accenture, where he led multiple enterprise projects for multiple Fortune 100 companies. Jeff’s experience and expertise include a deep focus in the areas of product management, product strategy, product marketing and developing strategic partnerships. Jeff graduated from UCLA with a Bachelor of Science in Microbiology and Molecular Genetics. In his free time, Jeff enjoys spending time with his wife and sons and traveling and dining around the world. Jeff earned the Eagle Scout ranking as a Boy Scout and is an avid fan of any activities in the California sunshine.

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