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Pursuing ED collections? First, get clinical buy-in
When patient access leaders made the decision to revamp the ED collection process at NorthShore University HealthSystem in Evanston, IL, they immediately set out to obtain the support of the ED medical and nursing directors, says Cindy Geaslin, director of patient registration.
"There is a direct working relationship with the ED clinicians. They give my staff the green light to go to the patient," she explains. "We rely on them to let us know when the disposition has been made."
Registrars constantly monitor an electronic tracking board to see if an ED physician has identified a patient's disposition, says Geaslin. The physician doesn't enter the disposition until they've decided whether the patient will be discharged or admitted to the floor, she explains.
"At that point, the medical screening is complete, and we are free to ask for payment," she says. "But we don't want to rely just on the system." There is constant communication between the registration staff and the clinical staff, says Geaslin. "We cannot and will not discuss paying copays until the clinical team has determined the patient's encounter is closed and over," she says. This is due to Emergency Medical Treatment and Labor Act (EMTALA) requirements, she explains.
Members of NorthShore's ED registration staff play a dual role, says Geaslin, acting as registrars and unit clerks.
"Registrars are assigned to a team of physicians and nurses. They are responsible for all of the patients on that team," she explains. "They are right there in the clinical setting."