Reception Regina
"The MD isn't in today... Also you didn't bring me my coffee I like"
- speak with MA, Nurse, PA involved with case.
- Ask what they prefer. Don't need to buy them out, but a treat here and there is nice.
-Plan a time so you don't miss them (schedule with front office)
"I ask them if they want home health sometimes... most of them say no"
- Most patients do not know what home health is, and the service we can provide so they are unable to make that decision.
- Explain that patients come to YOU GUYS for your clinical expertise, and would like the same regarding their post op care.
"What's home health?"
- It is a service that is covered 100% by most Medicare plans that allows a skilled clinician to care for your patient in their home, until they are ready to attend outpatient. We have PT, OT, SLP, and SN.
"We work mainly with St. Luke's HH as we are supposed to send 50% of referrals each week to them."
- Show them what sets us apart (protocols, programs, clinicians, service area).
_ Ask them how we can be their preferred provider/ what they like about the other home health provider.
... no answer. (she seems to be screening our calls)
- Look at referral and see if there are any other contacts
- If you already had preop call you should have already obtained another contact.
- call MD's office to see if they have another contact on file.
- drive by?
"I get too many calls from home health"
- Sympathize.
- Ask how we can make communication easier.
- Discuss that they will only call for clinical related questions that are pertinent to the MD otherwise we contact PCP
- Explain the process of obtaining orders
- Explain that we have on call nursing staff to take calls off of their plate.
"We leave it up to the patient to choose what they want to do post surgery."
- Most patients do not know what they need post surgery, and don't even know if they need PT.
- They are looking for your clinical expertise, and wanting to use YOUR preferred provider.
"I had a home health agency before not treat my patient with the correct post op instructions... I don't want them messing up my patients. "
- Sorry to hear that. We are not like most HH services, and would love the chance to obtain your post op instructions and learn how we treat them, how YOU want them to be treated.
-explain protocols, explain booklets, explain tenants of the program
"The surgery went so well, the patient isn't homebound"
- Almost everyone who receives a THA/TKA/ post op surgery is homebound for at least a week. They are also on opioids for a certain period of time making it challenging to attend outpatient.
- We expect the surgery to go well, and with Dr. Sally's surgeries they always do... But they would still benefit from home health.
"I don't like to exercise. PT stands for Pain and Torture."
- Explain the importance of performing PT early post op: reducing risk of joint contractures, light movement promotes healing, and preventing blood clots.
- Explain what early PT will focus on gait training, pain management, education on precautions, wound care, and some exercises.... we also help ensure you are safe at home, review medications, and screen/ manage your other comorbidities. Explain other disciplines if warranted.
"I don't know what you all need to have an order for home health?"
- Write down clearly all that is needed for complete order.
- Make it easy to send the referral (email, fax, or even pick it up? )
"We let the case managers set the patients up with HH. That way we don't have to get involved."
- We have great post op programs that help your patients recover with MD SPECIFIC programs/ protocols.
- They are wanting YOUR expertise.
"My scheduler decides who is going to home health by asking if they live alone."
- While HH can be beneficial to people who live alone, it can be beneficial for many other people.
- Everyone qualifies for home health post operatively as it is considered a "taxing effort" for them to leave their home.
"You don't take all the insurances... so we have to send to multiple HH agencies."
- WE would love to work with all insurances, but just as you do not take all insurances we cannot either.
- explain that we want to give best quality care to patients and we need to be in network with insurances that allow us to do that, rather than dictate our care.
- Maybe bring in print off of payors, as we are in network with most, and many are tier one.
- Maybe offer sending referral to other HH agencies for them if we cannot take them
"I had home health last time, and they didn't do anything besides sit on their phone".
- Explain that you are sorry to hear that, and we hope to make a different impression.
- explain the services we provide, but also include that in order to have things paid for by insurance our clinicians will be documenting your care in their tablets.
"I know Surgeon Sally, she doesn't like to use home health. We send to outpatient anyways."
- Ask receptionist why she doesn't like home health to see if there is VALUE we can bring.
"We already have a preferred provider with St. Luke's Home Health".
- explain what sets us apart.
- pre-oping patients, service area, programs, protocols, our clinicians, our outcomes, our follow ups...
"My patients aren't homebound they drive to appointments. "
- per Medicare guidelines: It must be a considerable and taxing effort to leave their home therefore most / if not all patients early post op, are considered home bound for the first few weeks.
- They are on pain meds, they need someone else to drive them, they have precautions that limit them.
- They are allowed to drive / leave home for non medical things such as hair appointments, walk around the block or drive, and attendance of family occasions (infrequently). As well as medical appointments.
"Patients have the right to choose what HH agency they want"
- Agree, as patients do have the choice, and our welcome letters include this on them.
- explain that most patients do not know the difference between HH agencies and instead trust their MD's preference for outcomes.
"I went to outpatient last time. I think I will go again"
- I totally understand the benefits of outpatient and I agree with you, however in the meantime, we can treat your at your home for the first couple of weeks until you are ready to drive, off pain medications, and your wound is healed.
- We can help set up that appointment for you.
- you will get more therapy visits by having home health, and then attending outpatient.
"Dr. Sally is too busy to speak with you today. "
- speak with decision maker in clinic (MA, PA, Nurse)
- Explain that you don't want to take up too much of their time.
- Bring in outcomes! (can't hand them over to front office staff)
"It's better to have the patient up and moving and attending outpatient therapy."
- Yes we agree, however we are not doing anything different than what outpatient is doing for the first 2-3 weeks. (wound management, precaution education, home safety, mobility training, pain management)
- We can help bridge the gap between surgery, and outpatient.
"I don't want to sign off on home health because the paperwork is just too much."
- Sympathize.
- Maybe review what is important in the 485.
- show them how to sign 485 in portal.
- Talk about how it is their duty to take care of their patient post operatively... and that we will only contact them for surgical issues
"Obtaining referrals before being choiced by case management is illegal/ HIPAA violation"
-This is not true. MD's are allowed to send referrals where they please.
- Patients are welcome to choose another HH agency if they would like.
"My doctor didn't say anything about HH?
- WE have received physician orders from Dr. Sally and work with most of her patients early post operatively.
- If you have any concerns feel free to contact their clinic, otherwise can I take any of your questions/ concerns?