One-on-one training equaled dramatic results

After a price estimator system was implemented at St. Joseph East in Lexington, KY, the need for one-on-one training quickly became apparent, says Stephanie Stamper, patient access coordinator.

Registrars were shown how to use the new system, she explains, but they weren't really comfortable. They didn't become comfortable until they ran several estimates themselves, which gave them the opportunity to see how the final amount due was calculated.

"It's not as black-and-white as you would think, because insurance policies vary so much," says Stamper. "You have to get a feel for the different benefit plans."

With hands-on training, staff members soon realized that for some plans, deductibles are applied to the patient's out-of-pocket expenses, but this system didn't always work correctly, says Stamper. If staff members didn't enter the correct procedure, she adds, this process resulted in incorrect estimates. "We have to determine exactly what procedure to list, and tell the tool what the patient is coming in for," says Stamper. "That can be one of the trickiest parts."

Registrars depend heavily on the scheduling teams to enter the data that tells them what the patient is coming in for, she explains, and sometimes it is not entirely clear. "It may be abbreviated or a procedure that we are not familiar with," says Stamper. "Therefore, doing the research to find the correct CPT code or codes can be a challenge."

The estimator tool itself doesn't always have procedures listed using the terminology that is expected or familiar to the registrars, adds Stamper. For this reason, she says, registrars are encouraged to contact the physician's office to obtain the exact CPT code(s). "We want to provide the most accurate estimates possible," she says. "Some of our registrars actually make the effort to follow accounts which they have provided estimates for, in order to see how accurate the estimate was."

In the event that an estimate given by a registrar is significantly different than the final amount due, Stamper investigates further to learn the reason why.

"If it was something we did, such as entering an inaccurate procedure, we can avoid the same error in the future," says Stamper. "We can rest assured that we are providing the most accurate estimate available."