Accuracy may be key to revenue increases
If registrars are more accurate when completing registrations, fewer claims denials will result. This clearly improves your hospital's fiscal situation, but remains a daunting challenge for many patient access departments. Here are some steps taken by the patient access department at St. Joseph's Hospital Health Center in Syracuse, NY:
Every person responsible for registration in the network is audited monthly for face sheet and Medicare Secondary Payor accuracy.
"The audit also includes a review of the account to ensure the claim was passed 'clean' on the initial billing," says Carol Triggs, MS, director of patient access.
A monthly incentive program is used.
The face sheet and Medicare Secondary Payer audit is one-third of the program. The second component of the program is the attainment of a monthly copays collection goal.
"This is team-based, unlike the face sheet/Medicare Secondary Payer accuracy audit, which is based on individual performance," notes Triggs.
The remainder of the program is based on patient accounting attaining their monthly collection goals. "This third component reflects the importance of front-end accuracy on the back-end collections," says Triggs. "Our staff incentive program has been very successful over the past eight years."
Each area has goals specific to its service.
For example, pre-registration tracks the percentage of scheduled patient visits that are pre-registered. Centralized scheduling tracks the average call wait time to their call center.
"Our departmental goals also reflect our customer satisfaction scores, our percentage of clean claims passed, and the monthly percentage of claims denied for no authorization," says Triggs.
A career ladder ties into obtaining personal goals.
"Staff are invigorated to give their best efforts in attaining goals, when they understand the basis and importance of the goals set before them," says Triggs. "Education for both customer service and overall revenue cycle education is very important."
[For more information, contact:
Carol Triggs, MS, Director of Patient Access, St. Joseph's Hospital Health Center, Syracuse, NY. Phone: (315) 448-5379. E-mail: Carol.Triggs@sjhsyr.org.]