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Cleaner registrations from 'front-door' consolidation
a.l scheduling and registration functions now report to the access management team at Methodist LeBonheur Healthcare in Memphis, TN, as a result of consolidation of front door functions, says Jessica Murphy, CPAM, corporate director for patient access services. This has reduced fragmented reporting structures, she says.
"We have learned that in a health care setting that is large and multi-faceted, all scheduling and registration functions need to report to the access management team to ensure quality and adherence to policy and procedures," says Murphy.
This means a more seamless process for patients who might be seen in any one of the facilities, says Murphy, and provides accountability for consistency of services.
One of the best examples, says Murphy, is the department's approach to scheduling outpatient testing or therapy, outpatient surgery, and planned admissions. Previously, the ancillary service areas at each of the six hospitals decided individually how physician offices would access them to schedule their patients.
"That literally meant a string of phone numbers for provider offices to post by the phone, in order to know how to schedule any requested services from Methodist Le Bonheur," says Murphy.
Murphy's access team worked with the administrative teams at each facility to centralize all scheduling calls into one department.
"In all but one of our hospitals, that department reports to patient access," says Murphy. "Eventually, we hope to have one scheduling division across all hospitals, providing 'one-stop shopping' for our providers to schedule patients for services."
"Scheduling is a critical partner to registration/admissions," says Murphy. By joining those functions into patient access and having a single reporting structure, she says, there has been a significant improvement in the quality of registrations. Here are some examples:
Registrations are more accurate, because a thorough search is now made for the patient's existing medical record number.
Scheduling errors were reduced, such as scheduling inpatient-only procedures as an outpatient status.
Out-of-network patients are redirected to in-network facilities for non-emergent services.
Spelling errors have been reduced.
"Scheduling staff have a newfound understanding of the information they gather, and its importance to the registration process," says Murphy. "This allows them to be a vital part of protecting the financial front door."
The pre-certification specialist nurses from utilization management were moved to patient access services for all outpatient services. "They have become part of the team that consolidates and drives front-door activity for our patients and our providers," says Murphy.
Schedulers and registrars turn to these nurses to get questions answered quickly and easily, says Murphy.
"Their clinical expertise helps the schedulers and registration associates with questions, ranging from medical terminology to payer contractual financial requirements," she says. "We have experienced significant improvement in adherence to access policies and procedures."
a.l of these areas now work together as a team with a single mission, says Murphy to get a clean registration that gets the claim paid efficiently.
"In my role, I can participate in and affect decisions and process designs for any of these areas, not just admission- or registration-related functions," says Murphy.
The "finger-pointing blame game" does not work well within a structure of single, direct reporting, adds Murphy. "Instead, it becomes a matter of the team itself working to improve processes, or re-structure education, when there is a bump in the road," she says.
[For more information, contact:
Jessica Murphy, CPAM, Corporate Director for Patient Access Services, Methodist Le Bonheur Healthcare, Memphis, TN. Phone: (901) 516-8162. E-mail: MurphyJ@methodisthealth.org.]