In the past, the patient access department at St. Peter’s Hospital in Helena, MT trained using a “very reactionary approach,” says Devon Murray, executive director of the revenue cycle. “We relied mainly on denials and complaints to drive our continued education.”

Patient access managers only followed up with staff when specific concerns were raised, such as missing insurance information or incorrect patient information causing claims denials. “We are rolling out a much more proactive approach,” says Murray.

Managers now use leadership reports and individualized scorecards to track each individual’s performance in relation to quality and productivity. “We set targets for each area of patient access to achieve,” says Murray. “All employees that do not meet these targets receive additional training to help them succeed.”

Registrars can see how their performance compares with previous months and departmental expectations. “This allows staff to identify opportunities and take ownership for their own success by making consistent improvements month over month,” says Murray.

Murray says these three things are essential to effective patient access training:

1. Setting clear expectations.

Department expectations and policies and procedures are clearly outlined in training materials, and made available for staff to reference. “We are in the process of adding patient access-specific policies and procedures into our standard training manual,” says Murray. These include registration accuracy, privacy policies, and insurance verification.

New staff are required to read the manual and sign, noting that they have read, understand, and agree to comply with the policies. As policies are updated, changes are sent to all staff to be signed.

2. The ability to see how overall department and individual staff performance compares against industry benchmarks.

The department’s reports track registration accuracy, eligibility verification rates, the number of errors that have not been corrected within three days of the patient admission, and point-of-service collections.

3. Sending a consistent message.

“In order for training to sink in, it needs to become a part of your culture,” says Murray. These approaches promote consistency:

  • Reminding staff of policies and expectations during all staff meetings and regular huddles;
  • Providing additional one-on-one training to registrars who are performing below expectations.

“We have been working a lot to help staff make our systems work for them,” says Murray. For instance, the department has a real-time eligibility tool in place, but registrars don’t always interpret the benefits section of eligibility responses correctly. As a result, it isn’t clear if patients are really covered for their scheduled service. “They frequently miss valuable information,” says Murray. “We are training staff to read the entire response.”


  • Devon Murray, Executive Director, Revenue Cycle, St. Peter’s Hospital, Helena, MT. Phone: (406) 447-2787. Email: