Identify common goals: It's to your advantage

Goal is mutual respect

After a registrar immediately blamed a clinic because she wasn't able to verify a patient's demographics, Nicole Marsoobian, supervisor of pre-registration at Tufts Medical Center in Boston, sent her to the clinic for an hour.

The registrar saw only two coordinators at the front desk checking patients in and out of a high-volume clinic. At one point, with six patients waiting to be checked in and two waiting to check out, a coordinator was pulled away to interpret for a patient, which left one coordinator to perform all functions.

"It has changed the registrar's outlook. She learned that there are many reasons why processes may fall through the cracks," says Marsoobian.

Too often, patient access and other departments work against each other, which causes claims denials, patient complaints, and scheduling problems, says Stacy Calvaruso, CHAM, assistant vice president of patient management at Ochsner Health System in New Orleans. "In many facilities, I have seen a lack of communication between access individuals and clinical care areas," Calvaruso reports. "This causes a general misalignment of priorities. It affects the organization's overall success."

Calvaruso holds shared meetings with clinical areas on compliance-related issues, add-on services, and schedule reconciliations. She adds that the patient access leaders team must consistently reinforce the main goal of any healthcare organization: serving the patients. "The biggest hurdle that many leaders face will be how to get their team members to respect the value that each area brings to the other," Calvaruso says.

Many common goals

In fact, patient access shares many common goals with other departments, including quality assurance, customer service, patient satisfaction, and payment collection, Marsoobian says.

"Lack of communication between patient access and other departments creates a direct impact on revenue cycle processes," she adds.

There is a duplication of efforts due to resources not being shared and overlapping responsibilities, resulting in miscommunication and a lot of rework, she explains. "In addition, statistical data is ineffective and cannot deliver the accountability that drives performance. Not only is the organization affected, but the patient experience suffers," says Marsoobian. She recommends taking these steps:

• Create a workgroup, with department leaders meeting periodically.

"During these meetings, leaders can talk through ways to better manage common goals that work for everyone," says Marsoobian, adding that areas of focus might include patient complaints about long wait times or departments failing to verify key data fields at scheduling and check-in.

• Ensure that information flows between departments.

Marsoobian advises, "Always provide information from your department that can benefit other departments on a regular basis," such as a list of non-contracted and contracted insurance payers for departments, assignment lists of employees and their direct extensions, and contact information of financial coordinators.

• Encourage registrars to meet staff in other departments face-to-face.

Marsoobian sets up a specific time period for her staff to sit in other areas of the hospital, to obtain a better understanding of what different departments do. "During this hour, they can observe a 'day in the life of the department,'" she says.


Nicole Marsoobian, Supervisor, Pre-Registration, Tufts Medical Center, Boston. E-mail: