A new registrar at Lewes, DE-based Beebe Healthcare struggled after completing his required training. He did not come from an insurance background and, too frequently, the registrations he completed contained errors. However, he was very courteous and worked quickly.
Understanding that the information registrars are required to know to perform their job can be overwhelming for some, leaders met with the employee to discuss the situation.
“Thankfully, this employee recognized his struggles and was humbled,” Maurice T. Winkfield, director of patient access, recalls. The employee received additional training, real-time support on the floor, and an extended probationary period. “That gave us time to determine if he was going to make it,” Winkfield says. “Thankfully, this person caught on and improved, growing into one of the best registrars we have.”
Patient-access managers now schedule a monthly 30-minute meeting with each employee. “These one-on-ones are a great opportunity to find out a lot about the employee — personally and professionally,” Winkfield notes.
Since the meetings occur regardless of how the employee is performing, there’s no negative connotation. “It allows for feedback to be given constructively, without it feeling like being called into the principal’s office,” Winkfield adds.
Top Pain Points
Although Rose Bonet, patient-access director at SCL Health in Denver, schedules performance reviews at least quarterly, she acknowledges it’s difficult to find the time.
“Many patient-access associates struggle to stay invested without this review time,” Bonet laments. Here, leaders share the top areas with which staff struggle:
- Accurate completion of Medicare as Secondary Payer questionnaires.
“Many associates do not complete these correctly because of lack of understanding,” Bonet explains. “This a challenging area, but is also easily corrected.”
- Collections.
Although many registrars flounder with collecting money at first, it’s something that’s easily measured and improved.
“Tools for this include scripting — especially for overcoming objections — understanding insurance benefits, and associate shadowing,” Bonet offers.
Leaders realize that collecting money from patients is intimidating for some registrars.
“Offering incentives seems to assist, especially when the incentives are generous, clear, and goals are attainable,” Bonet says.
- Multitasking.
Registrars act as a receptionist, a cashier, give directions, and escort patients, among many other roles. “Learning how to prioritize those tasks — and when to call for help when you have 15 people waiting to be registered — is something a lot of staff struggle with,” Winkfield notes.
- Productivity.
Beebe’s patient access department recently conducted a Lean initiative for the registration process and found all kinds of distractions caused delays.
“Phones ringing, patients walking up to ask questions, or getting up to obtain forms all limit the amount of registrations someone can complete in a given shift,” Winkfield explains. The department is switching to a standardized process that limits the amount of movement the registrar makes.“We tested this at one of our sites,” Winkfield says. “We saw immediate results and increased registrations per staff member.”
Bonet posts metrics for productivity and collections publicly, with the employee’s name visible to colleagues.
“As an associate who promoted up, I like transparency in metrics,” Bonet says. “I have even seen positive peer-to-peer coaching as a result of this level of transparency.”
At Reading (PA) Health System, whether the employee’s name is posted publicly depends on how well a particular patient access team is performing. Patient Access Director Paige Popp finds transparency works very well for high-functioning teams. “In addition to recognizing the outstanding individual performances, we openly share individual productivity results with the team,” she says. This creates healthy competition within these high-performing teams.
“However, we also have some teams that are not as high-functioning, and individual comparisons become more sensitive,” Popp says.
Winkfield distinguishes between the type of metric shared. Collection totals have been excellent motivators. When it comes to quality or productivity, though, it’s a different story. Because morale is affected negatively for low performers, he avoids direct comparisons: “It hurts the team dynamic.”
SOURCES
- Rose Bonet, Program Director, Patient Access Operations, SCL Health, Denver. Phone: (303) 272-0438. Email: [email protected].
- Paige Popp, Director, Patient Access, Reading (PA) Health System. Phone: (484) 628-5225. Email: [email protected].
- Maurice T. Winkfield, Director of Patient Access, Beebe Healthcare, Lewes, DE. Phone: (302) 645-3292. Fax: (302) 644-7016. Email: [email protected].
Leaders Share Top KPIs
Maurice T. Winkfield, director of patient access at Beebe Healthcare, names these as the top key performance indicators (KPIs) for his department:
- For centralized registration and ED: registrations per hour and average registration time;
- For schedulers: call handling time, scheduled appointments, and calls answered per hour.
- For the entire department: registration accuracy rates (all staff are expected to hit 98% accuracy rates) and point-of-service collections.
Patient access leaders at Reading (PA) Health System focus on three areas when giving feedback to individual employees. These are collections, registration accuracy, and patient satisfaction.
“This is linked to their performance expectations and annual performance appraisal goals,” notes Paige Popp, director of patient access.
In addition to these three KPIs, feedback on individual productivity is a major focus. “We have used multiple approaches to drive improved results,” Popp says.
Recently, employees were entered into a gift card drawing if they exceeded their collections compared to the previous month. “This incentivized some of our employees who previously collected less than their peers,” Popp reports. “As each employee strives to achieve more, the entire department benefits.”
The department also uses trivia contests to test employees’ knowledge of key topics. The winners are given gift cards. This sharpens employees’ skill sets.
“It also challenges others to become educated on the subject or process,” Popp notes. “This results in a group of higher-performing employees.”
Face time can make all the difference.
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