Toot your own horn to command long-overdue respect for access
Department is 'underestimated and unrecognized'
Patient access often is the recipient of all kinds of negative feedback - from patients, other departments, and even senior leaders. It's up to you to get the word out about your department's successes.
"Patient access is one of the most underestimated and unrecognized departments in the health care setting," says Connie Campbell, director of patient access at Mercy Medical Center in Oshkosh, WI. "It is often entry-level pay for the critical things they need to do. In light of that, you do need to toot your own horn. But none of us are very good at that."
For a very long time, patient access has been thought of as people who "only know how to type," says Suzan Lennen, CHAM, manager of patient access at Saint John's Health System in Anderson, IN. "After 35 years of experience in patient access, I can very firmly say that we have to know far more than typing skills."
Today's patient access representative must have knowledge of insurance eligibilities, payer requirements, Medicare and Medicaid rules, and systems for ordering tests in clinical systems by non-clinical personnel, "not to mention the vast customer service skills each person must keep as a top priority with our patients," says Lennen.
Unlike other areas of the hospital, however, patient access is not accustomed to calling attention to its successes. "We are busy taking care of the patients' needs as quickly and as efficiently as we can," says Lennen. "There is not much time to sit back and reflect on our achievements."
There is no question that what patient access does affects all parts of the organization - ancillary departments, nursing, food services, pharmacy, health information management, and patient billing. "But if we don't make known what we are doing, it is usually left unnoticed. Many times, the only 'notice' patient access will receive is when things are not right," says Lennen.
Patient access staff are unfairly depicted, for instance, as being incapable of getting the right registration information. "What is not known by other departments is the amount of time that a representative will take to track down the right information," says Lennen.
If the registration representative is not able to talk directly with the patient, he or she must rely on historical information, or that of family and friends. "There are also times when patients decide not to give us accurate information, making our efforts even more difficult," says Lennen. "Sometimes the inaccurate information is not caught until after the fact. The 'clean up' of wrong or false information then has to be corrected at nearly every point the patient 'touched' while in our facility."
Show bottom line proof
Campbell says that "'out of the ordinary' patient encounters do need to be highlighted. Always telling your department's story or highlighting one of its recent efforts is essential at any meetings the patient access manager attends."
Recently, a customer at Mercy Medical Center got separated from his wife on their anniversary. As they waited for each other at opposite doors of the hospital, access staff helped them find one another, and then gave them a bottle of "bubbly" - apple juice. "We keep four bottles on hand at all times for special occasions that staff can use for patients," says Campbell.
This is an example of an "out of the ordinary" effort by access staff, which Campbell goes out of her way to call attention to. Another involves a tradition started by access staff during the holiday season. Black-and-white photos are taken of children, with parental permission, and these are hung on the department's 16-foot Christmas tree. Each family is then sent a holiday card with the child's photo.
According to Catherine M. Pallozzi, CHAM, CCS, director of patient access at Albany (NY) Medical Center Hospital, "the proof is in results. We report through finance, and finance is a bottom-line world. In turn, my department speaks in bottom line success stories."
Goals and objectives are created each year for the department. "I report quarterly progress to my boss and this is provided to my senior executive," says Pallozzi. "I pride myself on the department's ability to achieve its goals. The only way to make it happen is with a strong leadership team that embraces the goals and objectives of the department as their own, and holding their staff as accountable to our success as I hold the leadership team."
A monthly newsletter is sent to Pallozzi's boss and senior director, with key performance indicators listed. "All literature points to recognition as a key to retention. Recognize and celebrate the smallest and greatest of successes," says Pallozzi. "You cannot wait for someone else to do it for you."
Pallozzi says to call attention to your copayment collections, both as a department and for individual achievements, registration accuracy, Medicare as a Second Payer accuracy, turnaround times, patient throughput times, and collection of high-dollar accounts.
Pallozzi sits on the hospital operations group, and is required to report key performance indicators twice annually. "I take full advantage of apprising executive leadership on copayment collection year to date, improvement from the previous year, as well as any significant strides made in the improvement of accuracy rates," she says.
Individual accomplishments regarding accuracy are noted in the department's monthly newsletter. "We have a Medicaid application unit, and we know how difficult that process can be," she says. "I have had staff work doggedly to get the needed documentation on six-figure accounts. Imagine how good they feel when they have secured the Medicaid funding."
As for the reputation and image patient access has at your hospital, "how you and your staff conduct yourselves, during all your interactions with physicians, patients, co-workers, and colleagues, can be a very significant gauge of that," says Pallozzi. These customer service interactions, whether done by phone or face to face, answer the question: "Are you providing the department what they are expecting and delivering each time?"
Go above and beyond
"The patient access staff must be able to multi-task on many levels," says Lennen. "There are times when a registration representative will see a need from a patient, and go above and beyond to see that need is met."
This might entail something as simple as pointing out the location of a hospital department where a patient is to receive a diagnostic test, or as complex as finding out if Medicare will pay for it. Or, a physician office may call to give information on a direct admission to the hospital, while the registrar who answered the phone is in the middle of registering a patient who is very ill and needs to get on to their testing site in an optimal time frame.
"When we do receive a compliment from a patient, we make sure the people involved in that person's care while at our facility know that they were appreciated," says Lennen.
Such compliments are sent on to senior leadership, including the hospital's director, vice president, and president. Occasionally, the president will send a thank-you letter, along with a small gift. "Something as simple as a thank you can be so important," says Lennen. "Sometimes the 'above and beyond' things that take place are common-sense types of issues. But these are still are important to the patients."
Recently, an access staff member loaned a family her child's car seat after they had been in an accident and were being transported by friends to another location after their emergency department visit. "The registrar didn't have to do this, but it was what was needed at the time," says Lennen. "Many other things that are in our scope of care as patient access occur every day."
Staff routinely help patients figure out which of their many insurance cards are the current ones, explain patient privacy rights, and obtain the proper consent for each patient that enters for care. Each staff member must know the hospital's policies, as well as state laws, for what is considered a legal consent.
"We are in an economy that is struggling, especially with the issues of health care costs," says Lennen. "It is vital that those of us that are working to ensure the right information is obtained the first time, are recognized for the efforts made, every day, every hour, for every patient."
[For more information, contact:
- Connie Campbell, Director of Patient Access, Mercy Medical Center, 500 S. Oakwood Road, Oshkosh, WI 54904. Phone: (920) 312-0002. E-mail: [email protected].
- Suzan Lennen, CHAM, Manager, Patient Access, Saint John's Health System, 2015 Jackson Street, Anderson, IN 46016. Phone: (765) 646-8136. E-mail: [email protected].
- Catherine M. Pallozzi, CHAM, CCS, Director, Patient Access, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208. Phone: (518) 262-3644. Fax: (518) 262-8206. E-mail: [email protected].]
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