Technology, staffing head conference topics

Capturing signature can be challenge

Technology advancements, patient identification concerns, and staff turnover were among the hot topics at the 2006 conference of the North Carolina Association of Healthcare Access Management (NCAHAM) in Asheville, NC, says president-elect Charlynne Lynch, CAM, manager, financial counseling and emergency department (ED) registration at Wake Forest University Baptist Medical Center in Winston-Salem.

The technology discussion centered on the following tools, adds Lynch.

  • Intelligent, guided registration.

A template, based on the hospital's rules, placed on top of the registration pathways guides registrars through the process, she says. "It's less generic and more specific. If [the registration] is missing some vital information, it will ask for that."

In effect, this software takes the place of the myriad of "sticky notes on how to handle situations" that registrars put around their computer screens, Lynch adds. "If you get to the point that you're filling out an accident screen, for example, it prompts you with, 'Is there liability? Was this a car accident?'"

  • Electronic signatures.

"A lot of hospitals have a challenge in capturing a signature for the general consent form," she says. "Sometimes the nurse participates in that process, and sometimes it's left up to access."

In some cases, Lynch adds, the piece of paper with the signature might not end up with the medical record.

However, with a portable device with a notebook-size screen, similar to those used by the UPS she says, registrars can conveniently capture patient signatures as needed, including at the patient's bedside or in the emergency department (ED) treatment area.

One of the issues involved in obtaining consent signatures is that many patients, such as direct admits, don't go through the normal admission process, Lynch notes. "It's a challenge for patient access staff to be at every portal of entry to complete that registration."

  • Address verification.

The access department frequently gets complaints from the back end about bills that are returned because access personnel didn't capture the proper patient address, perhaps depending on an outdated one in the system or on a patient's driver's license, notes Keith Weatherman, CAM, MHA, associate director of patient financial services at Wake Forest Baptist and a past president of NCAHAM.

Address verification software does searches, not just with the U.S. Postal Service, but of the person's recent financial transactions, such as the payment of a telephone bill, that show the most current address, he says. "Technology is available that allows [the registrar] to prompt an address search during the registration process."

At present, Weatherman adds, his hospital is using this type of service in a batch mode. "If there is a questionable address and we put in an address indicator, it will trigger this file."

Another hot topic at the conference was the ongoing problem of staff turnover, Weatherman notes. "People want to know what others are doing in that area."

"The goal in registration is to 'get it right the first time,'" says Lynch, "but how do you equip staff members to be able to do that?"

"When you do get good employees, how do you hang onto them?" adds Weatherman. "You lose them to 9-to-5 jobs, and better-paying back end jobs."

State certification available

Also at the NCAHAM conference, Lynch notes, the organization's state certification examination was offered, and was taken by seven access professionals.

The exam, Weatherman explains, was established in the mid-'80s as an alternative to the more expensive national access certification exam offered by the National Association of Healthcare Access Management (NAHAM).

Since that time, he says, a number of North Carolina hospitals have made the certified access manager (CAM) credential a requirement for certain positions.

At Wake Forest Baptist, for example, those who hold manager or assistant manager positions in access areas must have the certification, Weatherman says.

(Editor's note: Charlynne Lynch can be reached at Keith Weatherman can be reached at