Two extra hours to 'shadow' staff

Trainers reallocated from classroom

In 2013, patient access leaders at UK Healthcare were seeking to maximize their training resources.

"We don't have a big training team. We have to make sure that we offer training that is effective and has the best ROI," explains Diane Ward, assistant director of admitting and registration.

In 2014, online training modules were developed for insurance terminology, establishing guarantor guidelines, and copay collection. "We just started to roll this out, but we are really excited about it," says Ward.

The modules help trainers to cover all the elements that have to be captured and verified at registration. "You need to meet both clinical and financial needs," Ward says. "Training has become very complex."

The online modules break up a large amount of material into smaller pieces so registrars can "soak up the information more easily," she says.

Because trainers are salaried, there were no direct cost savings resulting from online training. However, it allowed trainers to be reallocated from the classroom setting. "This is where we were looking for a gain, in moving to online training," says Ward. "We've started small with the subjects offered online, but already, we've been able reduce our classroom training by two hours."

Basics covered online

Previously, trainers had to cover all of the necessary material in the classroom setting - even basic insurance terminology.

"We found we were spending a lot of time in the classroom covering the basics and not focusing on the more difficult issues, such as MSPQ [Medicare as Secondary Payer]" says Ward.

Staff members are now expected to cover the basics themselves with the online modules. This approach frees up trainers to conduct focused audits and to work alongside individual staff members as they register patients. "By shadowing, that's when we figure those pieces that they may have missed in the classroom," says Ward. "When the trainer is right there next to them, it sticks with them." The personal attention has helped staff to master these challenging aspects of registration:

. Medicare patients who are dual-eligible.

Trainers help registrars to ask the right questions to obtain the information that is needed.

"You can practice in the classroom, but you never know what the patient is going to say when they are in front of you," says Ward. "Staff need to be able to weed through the information the patient is providing."

. Interpretation of data that payers send regarding insurance eligibility.

"Payers aren't very consistent in what they send back," Ward explains. "When you get in the real-world setting and you have hundreds of different plans, it can be overwhelming." This situation prompts a lot of questions that wouldn't come up in the classroom, which trainers then address on the spot.

. Application of what staff learned in the classroom on system functionality to actual patients.

"We have an added layer of complexity in that we have two registration systems," notes Ward. "This prompts questions, when staff try to apply insurance know-how and plug information into the system."

Jump in accuracy

Right after staff at Minneapolis-based Hennepin County Medical Center began using e-learning modules, "we saw a fairly decent jump in our registration accuracy, of about 2 to 3%," reports Steve Nilson, MEd, CRCR, project manager for revenue enhancement.

Employees were required to take two tests after the e-learning modules and to pass each with a score of 80 or above. The first was a 50-question multiple-choice exam completed online. Staff members received immediate feedback on their mistakes, and they were required to keep taking the test until they passed. "I think that it was a helpful tool to let them know where they were struggling and that they had to go back and learn it before they retook the test," says Nilson.

While scoring the second exam - a two-hour skills test - the proctor discussed any errors that were made with the test-taker.

Being able to ask questions of the proctor was "amazingly helpful," says Nilson. "Everyone got one-on-one training, specifically designed for the things they were falling down on."