To comply with the Emergency Medical Treatment and Labor Act, patient access leaders at Wall Township, NJ-based Meridian Health keep the emergency department (ED) registration process “clear and simple,” says access services trainer Donna J. Roettger, CHAA.
These steps occur when a patient presents to the ED:
1. Registrars do a quick reg.
“This initial process only takes a few minutes from the time the patient comes in the door until they are triaged,” says Roettger. During this encounter with the patient, registrars ask only for identification. Once the patient is entered into the system, an account number is created.
“That allows us to put the patient into the tracking system that we share with clinical,” says Roettger. “This assists in the communication between access services and the triage nurse.”
2. After the patient has been triaged, registrars collect the patient’s demographic data and insurance information.
“During that time, we are able to electronically connect with most of the big insurance companies, whereby we send out a request for insurance information,” says Roettger.
If the insurance company responds that the patient’s policy is active, registrars find out the patient’s co-pay or co-insurance. The insurance company sometimes responds that the patient’s insurance is not valid.
“Either way, we do not speak to the patient about their insurance or any money owed,” says Roettger. Instead, registrars make a note to return after the patient has been seen by the emergency physician. “No money or financial obligation conversation is to be initiated by the registrar until after the patient has seen the doctor,” says Roettger.
3. Registrars return to discuss the patient’s insurance coverage.
If the patient’s coverage is invalid, registrars ask if he or she has other insurance.
“Sometimes it’s just a matter of the patient having given us the wrong card,” says Roettger.
If there is no other coverage, registers tell the patient that any services rendered during that visit will not be covered. “We are able to offer a discounted rate if the patient pays in full for their ED service,” says Roettger.
If the patient’s coverage is valid, registrars discuss co-pays and/or co-insurances that are due. “The registrars also need to keep an eye on patients who are being admitted. We don’t want to collect the upfront discounted amount if the patient is being admitted,” says Roettger.
Each of Meridian Health’s EDs rewards top collectors in some way. One ED gives individual registrars a ticket for each collection, which is put into a monthly raffle drawing for a gift basket. “The more tickets a registrar gets, the more chances they have to win the basket,” says Roettger.
Monthly collection totals for each ED are sent to all patient access supervisors, so each of them can see how his or her staff compares to others.
“We have a continuous dialogue with registrars regarding collections,” says Roettger. Patient access managers give workshops on use of the electronic insurance communication program and collecting copays and co-insurances.
“We have found that just initiating the conversation with patients at the appropriate time produces results,” says Roettger. Registrars find that many patients are willing and able to pay at the time of service. “They appreciate the ability to take care of their obligation on the spot, versus waiting for a bill,” says Roettger.
- Donna J. Roettger, CHAA, Trainer, Access Services, Meridian Health, Wall Township, NJ. Phone: (732) 212-6309. Fax: (732) 361-9189. Email: firstname.lastname@example.org.