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Anne Broccoli received a Bachelor’s Degree in Health Care Administration from Mary Baldwin College. She has worked on and off for the University of Virginia and the health system since her first role at UVA Health in the 1980s as an Account Collector Patient in Financial Services. Broccoli recently retired from UVA HR, where she served as the Director of Benefits from 2007 to 2017. 

After “retirement,” Broccoli accepted the Billing and Collection Ombuds position in May 2021. She recently sat down with us to talk about the role and its impact on our patients.

What does a Billing and Collection Ombuds do? 

Broccoli: The Billing and Collection Ombuds is a neutral party that assists patients with billing matters that the patient believes have not been resolved through the normal Patient Friendly Billing processes. 

When patients contact you, what steps do you take to assist them?

Broccoli: First and foremost: I listen. Then, I talk with patients (or their family when authorized by the patient) about their issues or concerns and identify and evaluate options for resolving the issues. This includes (but is not limited to):

• Connecting patients with financial aid from UVA Health and other community resources.
• Providing other information and services that help patients through the billing, financial aid, and payment processes.
• Reporting problems with patient care to patient relations representatives at UVA Health.
• Reporting concerns about our billing, financial aid, and payment process to UVA Health leadership.

What does that mean for patients and their families? What do you do on a day-to-day basis?

Broccoli: The Billing and Ombuds role is currently a part-time position reporting to the Bush Bell, Administrator, Hospitality and Support Services. On a day-to-day basis, I handle new cases as they come into my office, as well as follow my ongoing, open cases. Because the cases can be complex, I generally spend a fair amount of time on some of my cases. I also participate in both the Patient Friendly Billing and Patient Relations Escalated cases weekly meetings. 

Overall, I help patients better understand their medical and insurance bills, financial aid and payment processes. I explain decisions made about these topics. I also help settle disagreements about what’s in these bills and connect patients with other resources to assist them.

Are there common themes with which you help patients? How do you handle help patients navigate the process?

Broccoli: Common themes include: Unexpected/high balances after insurance, requests for guidance on financial assistance/payment plans, balances in collection, coordination of benefits when having multiple carriers, charge and/or coding disputes, ER bills, and estimates for upcoming services. If I discover trends with the types of issues, I report them to the appropriate billing staff for process review and improvement.

Because this Ombuds role is unencumbered from any other work, I am able to commit as much time as is needed to my cases. This allows me to spend time on educating patients about financial assistance and payment options, billing matters, insurance provisions, and understanding large, complex bills.

How successful are these efforts? 

Broccoli: Of the cases I received to date, 94% of them were completed to the patient’s satisfaction. In other words, the patient better understood the billing circumstances and/or balance due, were satisfied with any decisions that affected their balance due, or accepted the outcome — even if it was not the one they had hoped for. The remaining 6% remained unsatisfied when a bill wasn’t reduced or forgiven, or otherwise disagreed with the outcome of the determination.

You recently worked to embed Ombuds and billing information on the UVA Health LGBTQ patient website. Why was this educational effort so important?

Broccoli: UVA Health has highly regarded and fast-growing LGBTQ services. LGBTQ-related services, procedures, and surgeries can have multiple steps and may span several disciplines. It is possible that a portion of these services may not be covered by insurance (if deemed cosmetic, for example), so it is important for patients to be as educated and informed as possible throughout their journey — to avoid unexpected and costly out-of-pocket expenses. 

The more information we can get to patient’s up front, the better. 

What are some resources that team members can share with their patients to help? 

Broccoli: Back to my earlier point, the patients should always be encouraged to first contact Patient Friendly Billing. That team has subject-matter experts and processes in place to help with the large majority of billing matters. 

The Ombuds is here for patients whose issues weren’t effectively resolved to the patient’s satisfaction through those channels. 

What’s your favorite part about being an Ombuds?

Broccoli: While there are themes among my cases, every day I encounter new and unique circumstances that keep me energized and loving my role. By Swedish origin, Ombudsman means “ear to the people” or “agent.” My role affords me the time to do as much listening as is necessary, educating where possible, and empowering folks to take an active role in learning and understanding the complex, and often intimidating, world of medical billing.

Financial literacy has to include a focus on healthcare costs and insurance, so to the extent that I can improve a patient (or family members) understanding and knowledge of billing matters, I consider that a success.

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If your patients have questions or concerns about their medical bills and charges or they want help going over what their bill covers, the UVA Health Ombuds is here to help. Patients can email or call Anne Broccoli directly (abd4f@hscmail.mcc.virginia.edu; 434.243.4249).