Registrars' skills may not be what you expect

Measure to see if they're below par

Before you attempt to measure how skilled your staff are, you might want to be certain your own skills are up to par.

"In order to evaluate the registrars' skills, front-end supervisors and managers must first ensure their own competency with the registrar position," says Tracy Abdalla, hospital access services supervisor at University of California — Davis Medical Center Hospital.

Patient access supervisors should work hands-on to keep up their own skills, advises Abdalla. She says to evaluate these areas annually at a minimum:

• Information about payers.

To be sure registrars are all receiving the same information about payers, give standardized tests to all your staff on a regular basis, advises Abdalla.

"This knowledge needs to be more than just the basic understanding of what HMO, PPO, or public funding are," she says. Registrars should understand how benefits are obtained, what eligibility criteria are, and how the payers reimburse for services, Abdalla says.

She uses the coding system for payer details in the hospital's registration system, along with sample insurance ID cards, to test registrars on their payer knowledge. "They should be able to use a patient's insurance card to accurately determine the appropriate payer code needed," Abdalla says.

• Understanding of the overall revenue cycle.

"The registrar has to understand not just the steps they take to complete a registration, but also the importance of each of these steps and how it affects the facility's ability to receive payment for services," says Abdalla.

Give additional coaching

Susan Bauer, patient access/central scheduling educator at Edward Hospital in Naperville, IL, has learned the most about the skill level of her registrars from randomly auditing 480 accounts a year. Bauer looks for these elements:

• correct insurance mnemonic used;

• accuracy of insurance ID and group number;

• patient's name matching the insurance card;

• accuracy of non-staff doctor information;

• guarantor accuracy;

• consent present.

"We've learned that we have an opportunity for improvement in several areas, based on the results," says Bauer. "This has helped us design future training."

If Bauer notices one employee having a difficult time with something, she assumes that others also are struggling. "This has been a good springboard for me on topics that I identify, and then am able to address with everyone," says Bauer.

The department recently created a patient access scorecard to help assess the educational needs of the staff, reports Bauer.

At TriHealth in Cincinnati, OH, this monitoring is performed in pre-registration, reports Stacey Bodenstein, general manager of admitting and registration. Feedback, additional training, or coaching is given as needed.

Scripting is occasionally developed to answer frequently asked questions from patients. "This is especially important after a process change," she says.