Are you totally certain contact info is correct?
Verify it electronically
"How hard can it be to get the right address and phone number?" is a question you might hear too often. In reality, of course, it's not as simple as it sounds.
"Valid, current contact information for our patients and guarantors has to be one of the most challenging tasks that registrars must tackle each day," says Jessica Murphy, CPAM, corporate director for patient access services at Methodist Le Bonheur Healthcare in Memphis, TN.
After seeing high returned-mail rates, and getting complaints from many other departments and providers that use the same contact information, Murphy's patient access department set out to make some changes.
"We knew we had to tackle this process more effectively," says Murphy. "Like most opportunities to extract information from patients, it is not what you ask, but the way you ask it."
The department set out to answer these two questions:
How are we asking questions about addresses and phone numbers?
Are we consistently monitoring and updating those demographic fields?
First, spot audits of returned mail were examined to determine whether staff were consistently verifying contact information. "It was quickly evident that we were not," says Murphy. "We would find addresses that were showing on recent encounters, yet mail was returned. We would contact the patient and find out he or she moved years ago."
The same inconsistency was found with patient phone numbers and alternate contact numbers. "We have tried to take that back to the registrar, and hold him or her accountable for accuracy and quality," says Murphy.
A new approach
When the management team sat with associates and listened to the questions asked, "we knew the scripting for those areas needed to be changed," Murphy says.
Instead of asking a patient, "What is your address?" staff are instructed to say, "Please give me the address where you receive your mail." This will sometimes prompt the patient to provide a PO box or other receiving station.
Staff also were stating an address and asking the patient if he or she still lived there. "The patient wants to complete the registration task and get on to the area where he or she will receive care," says Murphy. "So 'uh huh' and 'yes' are the most common responses, even if the address we reiterated has nothing to do with where they live."
To get more accurate phone numbers, staff now say, "Please give me the phone number you want us to list, in case your doctor needs to reach you."
"Those are the magic words that tend to get their attention," says Murphy. "Again, it's not what you're asking. It's how you are asking the question."
However, even after making these changes, Murphy says "we have not solved this problem. We have made good progress by providing education and having individual accountability for the quality aspects of all registration information."
Since many patients do not go to the trouble of updating their driver's license information, this is not necessarily reliable information. "We are going to go the route of many health care organizations and get on-line electronic address verification, so we can concentrate our time and effort on other aspects of quality data," says Murphy.
The department is now exploring ways to add e-mail addresses, cell phone numbers, other alternate phone numbers, and fax numbers.
"We know, however, we will still be faced with the dilemma of how to effectively ask for that information, and where to record it in our patient records, which don't currently have fields set aside for these data elements," says Murphy. "We will need to impress on our staff that these too can change. So they must verify, verify, verify."
Software being piloted
Patient access coworkers at St. John's Mercy Medical Center verify patient address information clearly and accurately during the registration process at each hospital visit.
"Although this is a required part of our registration process, we know that unavoidable factors lead to inaccurate demographic completion," says Stacey Hayes, the hospital's patient access director. These include language barriers, incomplete information provided by patients, or simple coworker errors.
For these reasons, Hayes says that simply verifying patient contact information is a challenge for patient access. "Most patients that present to our departments have other things weighing heavily on their minds," she says. "They're concerned about an upcoming test or procedure. They may have just received an unsettling diagnosis or may be simply sick or in pain."
These factors contribute to the patient's inability to always provide the most accurate information possible. "However, simply forgetting to provide a 'circle' or 'point' after the street name can lead to delivery delays, challenges in bill collection, increased bad debt, and unnecessary efforts to research returned mail," says Hayes.
A few of the hospital's access departments, including main admitting and pre-registration, are going to be piloting address verification software.
"The software appears to be extremely user-friendly. It is designed to integrate into our current electronic health record product," says Hayes. After staff enter all or part of an address, a search is done to check the data against the U.S. Postal Service's.
The software will provide either the accurate address information or signal that the address entered could not be identified. Once the appropriate address is found, it is automatically populated in to the address fields within the registration.
"Our goal, as we test this application, is to assist patient access coworkers with capturing the most accurate data possible," says Hayes. "This will result in timely mail delivery, a reduction in A/R days, and increased productivity for our distribution center coworkers."
[For more information, contact:
Stacey Hayes, Patient Access Director, St. John's Mercy Medical Center, St. Louis, MO. Phone: (314) 251-6518. Fax: (314) 251-7737. E-mail: [email protected].
Jessica Murphy, CPAM, Corporate Director for Patient Access Services, Methodist Le Bonheur Healthcare, Memphis, TN. Phone: (901) 516-8162. E-mail: [email protected].]
"How hard can it be to get the right address and phone number?" is a question you might hear too often. In reality, of course, it's not as simple as it sounds.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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