Patient access frequently needs to update all employees across the entire department quickly. Below are some strategies for time-sensitive training.

  • Use leads and supervisors to deliver material one-on-one or in small groups.
  • Have registrars confirm they’ve reviewed the material.
  • Give information repeatedly.

Simply reaching everyone in the department is the biggest training challenge for Orlando Melendez, system manager of patient access at Edward-Elmhurst Health in Naperville, IL.

Today’s patient access departments face constant changes that need to be conveyed quickly across the entire organization. “The healthcare industry is highly regulated, rapidly changing, and complex,” says Melendez.

Patient access staff are located at 25 different points of registration in 15 locations. “This makes it difficult to reach each staff member in person. We rely on email communication for delivery of training material,” he says.

Melendez has found these approaches effective:

  • Require staff to complete an attestation to confirm that they have reviewed the material.
  • Include a short test to ensure staff comprehend the information.
  • Relate the training topic to the staff member’s role in the department.
  • Explain the downstream effect of the process.
  • Use lead and supervisor-level staff to deliver training material one-on-one or in small groups.

“Typically, this delivery method is reserved for new processes or for time-sensitive topics,” says Melendez.

Insurance eligibility was a recent topic. The revenue cycle educator explained how doing this correctly connects with the patient’s experience.

“If staff correct any discrepancies at the time of service, the patient won’t end up getting a surprise bill,” says Melendez.

Give Info Repeatedly

“Repeat, repeat, repeat” is the mantra of Aimee Newson, senior director of patient eligibility for Atlanta-based nThrive. She offers these four steps to convey a process change to the entire patient access team:

1. Notify everyone by email, asking them to electronically sign to confirm receipt.

2. Follow up with an online update, allowing for interactive discussion if needed.

3. Test employees to determine their level of understanding.

4. Conduct internal quality auditing, to be sure the process change is actually being implemented.

“Everyone interprets what they are hearing a different way and change can be difficult for some,” notes Newson. “It is important to validate changes are occurring.”

Newson has assisted many patient access departments in compliance with 501(r) requirements. These require hospitals to make reasonable efforts to determine if an individual is eligible for assistance under the hospital’s financial assistance policy.

“The training challenge is getting the patient access team to understand what 501(r) means to them, and incorporating it in their day-to-day work,” says Newson.

Patient access must do two things.

  • Ensure patients are offered financial assistance when they have limited ability to pay.
  • Consistently follow the hospital’s financial assistance policy. 

Periodic auditing ensures this is done consistently, says Newson: “Identify trends in those patients tagged with financial assistance and auditing self-pay accounts notes.”

Reach All Registrars

Kaniesha Mason, CHAM, associate director of patient access services at Syracuse, NY-based Upstate University Hospital, struggles to keep the entire department updated on payer requirements.

“It is always challenging to stay ahead of these changes in time to get proper notification out to the end users,” she says. It’s also difficult to pull all employees from their registration locations for classroom setting training. The department also has to train both centralized and decentralized registration staff.

“Since not all registrars work for patient access services, it can be challenging to hold all staff equally accountable for thorough registrations,” says Mason. The department uses these strategies:

  • “Lunch and learn” sessions cover new processes or clarify existing processes.

“For employees who are unable to attend in person because of coverage, these sessions are also posted as mandatory training, with a short proficiency exam to test their knowledge,” says Mason.

  • A registration-related article is included in the monthly departmental newsletter, which is reviewed at staff meetings.
  • Employees regularly meet for 15 minutes with a supervisor.

“This provides an opportunity for staff to ask questions or demonstrate proficiency on any topic,” says Mason.

  • Cross-trained staff cover both emergency departments and central registration sites.

“We are able to share staff during peak times, and schedule more end users for face-to-face training,” says Mason.


  • Orlando Melendez, Director, Central Scheduling and Patient Access, Edward Hospital and Health Services, Naperville, IL. Phone: (630) 527-7472. Fax: (630) 548-7712. Email: omelendez@edward.org
  • Kaniesha Mason, CHAM, Associate Director, Patient Access Services, Upstate University Hospital, Syracuse, NY. Phone: (315) 464-9367. Fax: (315) 464-4005. Email: BarnettK@upstate.edu.