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Access training program hits the road, sharing success with other facilities
Arkansas provider brings hospitals together to share ideas
The University Hospital of Arkansas in Little Rock is taking its "Strengthening Bridges" program for access employees on the road and finding some additional benefits for the home crowd as well as for a new audience.
Opening the continuing education program to access employees throughout the state has allowed staff at the University of Arkansas Medical System (UAMS) to "see what other facilities go through and share ideas back and forth," says Holly Hiryak, RN, CHAM, director
of hospital admissions. "It gave them an opportunity to think outside the box."
Participants "bounced a lot of things off each other," adds Karen Lamoreaux, a UAMS revenue integrity specialist who is one of two main trainers for the program. "Plan codes come up quite frequently," she notes. "Each hospital has its own definition and uses. It was helpful to hear from others how many they have and how they clean them up and maintain them."
The Medicare Secondary Payer questionnaire was another topic of discussion, Lamoreaux says. "What does [the other hospital’s] look like? Where do they put the documentation in the computer?"
Hiryak decided to offer Strengthening Bridges — a two-day program that updates and reinforces access skills in such areas as insurance verification and compliance — after some networking with the Arkansas Association of Hospital Access Management (ARKHAM).
"I had presented the course outline and content at the last ARKHAM meeting, and that’s what sparked their interest," she says. "They came to see what we had to offer." (See more on the Strengthening Bridges program on p. 8 of the January 2002 issue of Hospital Access Management.)
Although outside students have come to UAMS to receive the training, Hiryak says, her trainers will go to other facilities that have at least five employees who want to participate. At $150 per person for the two-day program, the training is not a moneymaker for the health system, she adds. "Considering the materials we provide and the trainers’ time, we just cover expenses."
UAMS staff called the access manager at the participants’ hospital before the recent session, Hiryak says, "to get specific information about how they do certain forms, etc., so we could address that in the training as well."
Staff realized, however, after the first session that included outside participants, that some of the program material was not relevant to those who were not part of UAMS, Lamoreaux notes. "There was a section about the revenue integrity team and the audit process we do that was really UAMS-specific, as was the information about cash collections."
A chapter on the system’s financial hardship, or charity program also was not particularly helpful to outsiders, she adds. Although a brief section on billing issues remains, the outside participants no longer hear lectures by UAMS billing representatives detailing their program.
"Based on their feedback, we were able to make changes," Lamoreaux says. The class now has been reorganized so that the material specific to UAMS is covered the first morning, and students from other hospitals are brought in at 1 p.m., she adds.
In the afternoon of that first day, Lamoreaux explains, the trainers cover regulatory issues, such as COBRA/EMTALA, as well as information about Arkansas agencies, grants, and studies that affect access personnel. Insurance topics are the focus on the second day, she says.
Because there is so much about Strengthening Bridges that is specific to the state, including details of Medicare, Blue Cross Blue Shield, and fiscal intermediaries, the program really is appropriate only for Arkansas access personnel, Hiryak notes.
Compliments on communication
One of the positive things outside students point out regarding what they learn about UAMS has to do with the interaction between the registration and billing areas, Lamoreaux says. "They compliment us on how much we have improved communication between the frontline staff and the billing department. Many say they’re motivated to go back [to their facilities] and find better ways to communicate."
At UAMS, she explains, the revenue team — made up of Hiryak and four other team members — acts as the middle man in the process. "We audit the registrations and give feedback and conduct monthly inservice training classes. We act as the communication liaison between the registrars and physicians billing, hospital billing, the hospital compliance officer, and the office of business development [managed care]."
When there is a new insurance contract or compliance issue, for example, the revenue team members — who have fostered a personal relationship with the various players — transmit the information to registrars, Lamoreaux explains. In some cases, they might have someone from the appropriate department speak at an inservice.
To those who are developing training programs, she suggests looking at as many models as possible. "Holly did a lot of research," Lamoreaux says. "There is no sense reinventing the wheel."
She also advises patience. "It really does take a while for that wave motion to make it to the outskirts [of the organization]," she adds. "We’ve been doing this for over a year, and we’re just now getting the training to the point that we’re really happy with Strengthening Bridges."
[Editor’s note: Holly Hiryak can be reached at (501) 686-8170 or by e-mail at firstname.lastname@example.org. Karen Lamoreaux can be reached at (501) 686-6718.]