You should standardize your access processes
Executive Summary
Standardized registration processes decrease claims denials and increase success with cross-training, according to patient access leaders. Eligibility denials decreased by 14% each quarter in the last fiscal year at UK Healthcare.
• Costs are saved due to less overtime pay and fewer errors.
• Short-staffed areas can pull registrars from other areas.
• Patients expect consistent registration processes.
It’s critical to cross-training success
After standardizing registration processes, Lexington, KY-based UK Healthcare saw a decrease in eligibility denials by 14% in every quarter in the last fiscal year.
By cross-training members of the patient access staff, the department was able to "take advantage of economies of scale," explains Kevin McAuley, senior manager of patient access. "We have been able to spread higher volumes of work among more individuals within our pre-registration team."
According to David Kelly, director of revenue cycle at Mary Rutan Hospital in Bellefontaine, OH, standardization of patient access processes is "critical to success across the revenue cycle."
"A standard process minimizes error rates, thus minimizing opportunities for claim denials," Kelly says. "It can even potentially reduce risk and disparities of care."
Lack of standardization can increase overtime costs due to an inability to "float" registrars to other areas as needed. "Standardization can also lead to vendor consolidation, which is a cost-savings opportunity," adds Kelly.
Patients more satisfied
Patients don’t expect their registration experiences to differ depending on which site or service they’re using, says Kelly. For example, some locations might request copays while other locations do not.
"This can be a huge point of frustration for patients," Kelly says. "We don’t expect a trip to Amazon.com to vary based upon the computer we’re using. We expect it to be the same, every time."
The expectation for consistency is true for registration, he says. For example, a standardized approach to financial counseling ensures that all patients in all service areas are given the opportunity to discuss their liability, payment options, and options for assistance if needed.
"Standardization in patient access drives that same familiarity’ feeling that has driven lots of success throughout other industries," Kelly says.
Success with cross-training
Kelly says that in his opinion, "you essentially cannot effectively cross train without standardization." Although a walk-in lab registration is different from an emergency department registration or a scheduled admit, Kelly’s approach is to "embrace what can be standardized, and train diligently around the rest."
Mary Rutan Hospital’s patient access leaders are discussing how to best cross-train staff. While they haven’t yet done an analysis, Kelly says significant cost savings are expected. "Any area doing scheduling, pre-service, or registration can be standardized and cross-trained," Kelly says. "The difficulty becomes the nuances’ of each department and building a training program around those."
Patient access leaders at Bend, OR-based St. Charles Health System developed a standardized registration process for four hospital facilities and the pre-arrival services unit. "Our processes are standardized as much as possible," says Bernie Andreotti, CHAM, system manager for patient access services and pre-arrival services.
Training manuals and other registration resources are available on the hospital’s shared website. "This allows us to hold everyone accountable to the same standards. It provides for consistency at all sites," says Andreotti.
Patient access employees are available to work at any of the sites, and they need to do only a site orientation when they go to a new facility.
While Andreotti has not calculated the actual cost savings of standardized processes, she says there are decreased overtime costs. "But at times for us, it is not overtime. It is being able to keep a service open and not back patients out the door with the wait times," she says. "The amount of times that we have been able to share staff has been invaluable." (See related story, below, on benefits of standardizing patient access processes.)
- Bernie Andreotti, CHAM, System Manager, Patient Access Services/Pre-Arrival Services, St. Charles Health System, Bend, OR. Phone: (541) 706-7753. Fax: (541) 706-4734. Email:
[email protected].
- Myndall V. Coffman, MBA, System Director, Patient Access and Scheduling, Baptist Health, Louisville, KY. Phone: (859) 260-2162. Fax: (859) 260-6935. Email: [email protected].
- David Kelly, Director, Revenue Cycle, Mary Rutan Hospital, Bellefontaine, OH. Phone: (937) 651-6338. Email: [email protected].
- Kevin McAuley, Senior Manager, Patient Access, UK HealthCare, Lexington. Phone: (859) 323-8348. Fax: (859) 323-2021. Email: [email protected].
