Are patient access staff explaining consent forms accurately to patients? Are they interpreting and explaining insurance benefits correctly? Face-to-face recordings of registrations let patient access leaders at CHRISTUS Trinity Mother Frances Health System know these things for certain. “We listen to a sample size of recordings from random associates each month and report out on the findings,” says Tim Holland, MPA, CHAM, regional director of admission services. Here are two lessons the department learned from the recordings:

Staff were entering information into certain data fields inconsistently. This was mostly happening when patients refused to give their email address, or did not have one to provide. Some employees entered a generic fake email address (such as “”) into the data field. Others typed in a note about the patient’s refusal to provide an email contact.

“We even found some cases where an associate thought they were using a ‘generic’ format, but it turned out to be an actual email address,” Holland reports. This was corrected immediately because of concerns about patient privacy regulations, in the event the email was used to communicate with the patient about upcoming appointments.

Staff were not explaining consent forms to patients consistently. “This was extremely concerning for us,” Holland says. Leaders took immediate corrective action to ensure staff were relaying information appropriately. “Our forms have a lot of information on them,” Holland notes. “We require our team members to explain the ‘high points’ of the form before the patient signs.”

For example, the hospital’s consent form contains five boxes that a patient initials:

  • Consent for treatment;
  • Photography consent for clinical use;
  • Authorization for release and/or acquisition of information. This refers to releasing or obtaining protected health information (PHI) to or from third parties to adequately provide care;
  • Consent for electronic sharing. “We share PHI with other Epic facilities electronically when one of our patients utilizes another health system,” Holland explains;
  • HIPAA’s privacy notice. Instead of waiting for inevitable questions from patients, employees anticipate them. Not surprisingly, most concerns involve “authorizing the release of information.”

“We pre-emptively explain this point to patients to improve our efficiency,” Holland adds. Occasionally, the recordings reveal that some additional education is needed. “Where we run into trouble is when an associate says that the patient is giving us the right to release information as we please,” Holland reports. This incorrect statement would rightfully cause a patient to become concerned. Staff were reminded that the information is released only when requested or warranted.

Some associates offered no explanation at all about the consent forms; they simply asked the patient to, “please initial here.”

These issues arise from time to time. Interactive videos are used to help associates understand the forms better. “We provide multiple education opportunities to make sure we are covering the legal forms correctly with our patients,” Holland says.

Occasionally, a patient accuses someone in the department of acting overly aggressive with collecting. Sometimes, the complaint is about rude treatment. In the past, this was a “he said/she said” situation, but it is no longer a mystery for leadership. “We now use the recordings to either validate or disprove the patient’s complaint,” Holland says.

Most of the time, it turns out that the employee was not really at fault. One patient claimed they were “badgered” for money. In reality, the patient was politely asked for payment a single time. When the patient stated that they could not pay, the conversation moved on, and registration was completed.

On the other hand, collection practices sometimes really go too far. In these cases, appropriate action is taken. “But overall, the recording tool is not used as a ‘Big Brother’ approach to managing our teams,” Holland notes.

The emphasis is on providing the best possible service for patients. Employees also realize they are protected from unfounded complaints. “The program has been very well-received by the majority of the team members,” Holland says. “We consider it to be a huge win for the department.”