New HGH Representatives Help Patients Navigate System

Humboldt General Hospital has launched a new department designed to help patients circumvent the many barriers—financial, logistical, and social—that make it difficult to use the healthcare system.

The Patient Access to Healthcare Department (PAH) is the brainchild of HGH Radiology Manager Pam Wickkiser who saw patient stress significantly decrease for imaging patients when she added a patient navigator to her staff.

Wickkiser said that person was able to discuss costs with patients, secure pre-approvals from insurance companies and schedule appointments at the most convenient times possible.

"After our experience in Radiology, I just knew this would be a great model for all hospital patients," she said.

"Our goal is to decrease barriers—and financial barriers are probably the biggest and the most common barriers that our patients face."

In addition to Wickkiser who acts as the department's director, the new Patient Access to Healthcare Department includes Patient Access Team Leader Theresa Chwastek and three representatives: Debra Ames, Lyndsi Jurado and Lu Steepleton.

All of the staff members are available to discuss estimated costs, insurance coverage, Medicare and Medicaid, and any other qualifying funding programs.

The employees can also help patients complete applications, discuss current bills, payment plans, and simply act as patient advocates.

Wickkiser sees the new department as a huge step forward in helping patients feel more comfortable and more in control of their healthcare experience.

"We live in a different time now, where each person needs to manage his or her own health," said Wickkiser.

The new director said she is the first to admit that managing healthcare can be daunting.

"When hospitals interact with patients, sometimes it can seem like they're speaking a different language," said Wickkiser.

"That's where we come in. We can be there to help translate, and help navigate the system. We can help with the forms and the appointments and everything that needs to happen for our patients to achieve their greatest healthcare success."

Wickkiser said she hand-picked her new staff for their kindness, accommodating manners and their quick thinking.

"Our team is ready to look outside the box if necessary or go different routes or do whatever we need to do in order to help people find the solutions they need."

Wickkiser said the new department actually came to fruition following some constructive suggestions from community members.

"We had folks who wanted to know how much their procedure was going to cost, and how they could use that information to know what their insurance would pay, and if they could schedule a payment plan."

Wickkiser said other community members voiced concern with other relevant issues, "and pretty soon it became apparent that this was a service we needed to offer to our community," said Wickkiser.

Wickkiser said the hospital's decision to handle its billing off-site has also added to patients' confusion and frustration.

"We want people to know that they can come talk with a representative here, in Winnemucca, and we can help," she said.

HGH outsourced its billing to a private company in December 2009.

Hospital officials said that as a fiscally responsible organization, HGH had to acknowledge that it needed help to get its billing into a more manageable situation.

"We opted to follow on the heels of most hospitals across the nation, both rural and urban (like St. Mary's in Reno), who have taken the same route," said HGH CEO/Administrator Jim Parrish.

Parrish explained, "Medical billing is a highly specialized field. It is extremely expensive and difficult to train billers and we simply could not effectively process our accounts receivable in-house."

Parrish said the hospital processes just under 10,000 bills a month. "At one point, our billing department was 154 days out from the time care was provided to the time a bill was issued," he said.

Parrish continued, "Through the absolute hard work and tenacity of our billing office staff, we were able to reduce those days out to 70 days, which was an unbelievable drop at unbelievable sacrifice on the part of our staff members. But we never could get below that.

"We should be somewhere between 52 and 55 days. If we go much above that, our patients have to deal with a multitude of insurance and other headaches.

Plus, Parrish said if one of the billers was gone for a few days due to sickness, vacation or training time, the hospital's days out immediately started inching back up.

"It was a miserable battle and one that I think our billing office was glad to hand over to a national company that specializes in such practices," said Parrish.

Still, Parrish said the hospital continues to work out the kinks in the system, and that's where Pam and her department come in. I am confident that if there is any confusion or frustration in this process, our new access representatives will be able to capably help our patients get the right information and use that information to make their most informed decisions."

Wickkiser said she and her team have been buoyed by patients' response to their department.

The group recently visited the Humboldt County Senior Center where they shared information about their department with the group, but also took the chance to visit with seniors one-on-one at their tables.

"That was a sweet opportunity and just a small taste of what's to come," said Wickkiser.

"We want our whole community to know that we are here and we are available for whatever their needs are, whether it's working out a payment plan, finding out the cost of a procedure or seeing if there are any funding programs that can help with their medical care."

Wickkiser continued, "We are here to act as advocates for our patients; we are here to be a friend and a support for the patients at Humboldt General Hospital."

Representatives with the Patient Access to Healthcare Department are available by appointment from 8 a.m. to 5 p.m. Monday through Friday.

To schedule an appointment, please call (775) 623-5222, ext. 533.

Patients may also drop by the HGH Business Department to speak with a PAH representative. Representatives will meet with patients on a first-come, first-served basis.