EXECUTIVE SUMMARY

Patient complaints and claims denials stemmed from discrepancies between their preferred and legal names at Ochsner Health System. To address this:

  • a separate field was created for the patient’s preferred name;
  • staff and clinicians know how patients want to be addressed;
  • the correct name goes on the claim without disturbing the integrity of the medical record.

The name on a patient’s ID often differs from the name they give to the registrar. This can happen due to a recent marriage or divorce or some other reason. Regardless of the reason, it was a common cause of dissatisfaction in registration areas at Ochsner Health System in New Orleans. One patient complained that her medical record listed her previous last name and that she recently re-married, but her driver’s license still contained the last name of her former husband. She stated that being referred to by her previous last name brought back memories that she preferred to forget, and wanted her information in the system changed to reflect her new last name.

“This is a frequent complaint that I am happy to say is no longer an issue,” says Mary Neal, MBA, CHAM, director of patient access services.

Registration’s policy is to use the name on the patient’s legal ID for the medical record. This is important for patient safety and identity protection.

“However, frequently, patients do not go by their legal name, and, for whatever reason, have not updated their documents,” Neal notes.

Some patients want to be called by their middle name or use a long-standing nickname.

“Whatever the reason, this seemed to always be a source of frustration on the part of the patient, even when given a clear explanation by a leader,” Neal says.

Correct Name on Claim

Some claims were denied, stating “Member Not Found” because the name listed on the claim did not match the name the insurance company had on file. “Many patients argued that their legal name is not the name that appears on their insurance policy,” says Lakeshia Lewis, manager of patient access services.

The discrepancies in patients’ names caused hours of reworking claims. The back-end team submits the claim, the payer denies the claim, and the team then has to investigate the denial, obtain the correct information, and resubmit the claim.

“This takes time that can be better utilized for other tasks. The hours used can turn into days,” Lewis laments. Once the name was corrected, the claim had to resubmitted. “Luckily, we were still within the time period to meet ‘timely filing,’” Lewis notes. “However, this does have an effect on our accounts receivable days.”

To address this, patient access created a separate field in the registration workflow for “Name on the Card.” Registrars place the patient’s name and date of birth in this field, exactly as it’s listed by the insurance payer. “This is the name and date of birth that is populated on the claims, and, therefore, will match with what’s on the file with the payer,” Lewis explains.

Previously, claims were denied because the patient’s name on their driver’s license contained the new or former last name of the patient, which didn’t match what the payer had on file. With the new system, the correct name goes on the claim without disturbing the integrity of the medical record. “But even with this fix in place, we still had complaints,” Neal adds.

Popular With Patients

Last year, the department made another change. They implemented a “preferred name” system for all patients. New patients are asked for their “preferred name” so everyone knows how the patient wants to be addressed.

“Since implementing this, we have not had any complaints related to legal name,” Neal reports. “It has been quite a success.”

All team members use the patient’s preferred name when addressing the patient.

“This allows us to register the patient under their legal name. But we also list the name or nickname the patient prefers,” Lewis explains. The new system has been especially popular for patients in these registration areas:

  • The pediatrics clinic.

Calling children by their nicknames creates a calmer environment for both patients and parents. Lewis recalls that the first day the new field had been implemented in the registration system, a child was visibly afraid. “But when the nurse and doctor spoke with the child using their nickname, you could see the anxiety and nervousness leave,” Lewis says.

  • The endocrinology clinic.

The preferred name option allows registrars to address patients who are transitioning to a different gender with the name and pronouns they prefer. Recently, a patient provided feedback indicating that this made a big difference. “She shared that it made her feel we gave her the compassion and respect that she deserved,” Lewis says.

SOURCES

  • Lakeshia Lewis, Manager, Patient Access Services, Ochsner Health System, New Orleans. Phone: (504) 842-0352. Email: lakeshia.lewis@ochsner.org.
  • Mary Neal, MBA, CHAM, Director, Patient Access Services, Ochsner Health System, New Orleans. Phone: (504) 842-0322. Email: mneal@ochsner.org.