Online resource gives staff instant payer info
Improve registration accuracy
An Intranet application at Christiana Care Health System in Wilmington, DE, was developed specifically for patient access staff to improve registration accuracy.
"In there, we have all the insurances that could possibly come here listed," says David Charles, corporate director of patient financial services.
Access staff simply click on the insurance the patient is presenting with. That brings the user to a page with images of the actual cards from that particular payer, including the one the patient is holding. From there, the staff person can launch to another page with all the rules associated with that particular payer, down to the individual card that is selected.
"The registration person knows definitively what the coverage is associated with that payer," says Charles. "After the cafeteria menu, it's the most hit page in our system."
Patient financial services has the current responsibility for updating the Intranet site. "The reason for that is they are seeing the denials and the activities," says Charles, "and they are closer to the contracts than access is - also, because it all reports up through me anyway, it was six of one and half a dozen of the other."
Accounts are cleaner
The site came about as a result of brainstorming for ideas during an outpatient workgroup that was formed several years ago. "We were trying to figure out what the outpatient areas really needed, and one of the glaring things they did need was some kind of source of information," says Charles. "In realizing what electronic capabilities we have, we developed it on our own."
Before the tool was implemented, Charles says "there was a lot of going back and forth - we either had the wrong insurance or the wrong ID. Now, between the Intranet, electronic verification, and our denial tracking systems, our denials are extremely low," he says.
As a direct result of the Intranet tool, Charles says "there was a significant decrease in days receivable and our accounts got a lot cleaner."
Charles says that the biggest educational challenge for patient access is the fact that registration is decentralized. "We do not have a core area to which all departments report. The good news is, every department is handling their own registration for those low-ticket items," says Charles. "But the bad news is that we have to be really diligent about reporting their errors and making sure they are informed about changes."
Patient access pre-registers all elective cases, such as surgical patients who are called at home for coverage verification and registration. For routine diagnostic services, departments do their own registration. "That was one of the key reasons why we did the Intranet. They had confusion about what payers they could accept and were using cheat sheets. In order to keep them informed, we decided to go with that approach," says Charles.
Here are other ways that Christiana Care's access staff members are educated:
In-person visits are done after orientation.
All of Christiana Care's new registrars attend a two-day orientation, which covers the system's functionality and concepts of admitting. Items such as the Medicare as Secondary Payer questionnaire are covered in detail, both how to complete it and why it's important.
However, registrars may not realize their own knowledge gaps until after they're on the job. For this reason, onsite visits are done a couple of days after the orientation.
"We visit the site that the registration person is going to and do a follow up in real time to clarify any questions they may have," says Charles. "We usually do that two or three days after they hit the department."
At that point, new staff may have questions on "some of the finer points of registration," says Charles. "They may ask whether they are on the right screen."
Another purpose of the visit is to observe the registration person firsthand. "We can see how they are dealing with the public and make sure they have the customer service comments down correctly and are utilizing the system in the correct way and making the proper selections."
Errors are tracked by individual staff member and appropriate training is given.
Christiana Care's access department has developed quality reports by registration person, known as "Q Reports." These track the number of errors they are making as a percentage of their total registrations.
"We target a certain percentage of errors, which is different by topic, and when you cross that threshold we go back and do retraining on you," says Charles. "We put account notes in the system, such as, 'Were all patients selected?' And we tag the error by account notes and go back at the end of the month and accumulate all those by registration person. We share information with department heads about what kind of errors are being made so they are also well informed."
An Intranet application at Christiana Care Health System in Wilmington, DE, was developed specifically for patient access staff to improve registration accuracy.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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