ID unique challenges with ED accuracy
ID unique challenges with ED accuracy
Registrars cope with ‘chaotic’ environment
As a new manager in the emergency department (ED) setting, Shante R. Hill, manager of the patient access revenue cycle at University of Mississippi Medical Center, Jackson, discovered some unique challenges with registration accuracy.
“Inaccuracy can be as simple as misspelling a patient’s name or using an incorrect date of birth,” says Hill. “Misidentifying a patient will most likely generate insurance claim denials.”
An ED registrar often has limited time to obtain information. “The ED environment can be rapidly chaotic. A registrar can easily create errors simply by moving too fast,” says Hill.
Some patients are transported unresponsive and rushed immediately to surgery. Other patients might supply inaccurate information because they’re presenting in a traumatic state.
“Your family may refer to you as Ann, but your actual name is Angela. A simple mishap can cause chaos for the patient and the facility,” says Hill. “This would be a great time to ask for identification cards and insurance information to ensure accuracy.”
There are times when the registrar takes on the role of an investigator to obtain patient information, says Hill. “Many resources are utilized, such as the Internet, historical chart information, and contact information for next of kin,” she says.
ED registrars also rely on the emergency medical services (EMS) team, who might have communicated with the patient during transport. “Our department also has a follow-up process,” says Hill, adding that a new electronic health record system traces the encounter from start to finish. The system acts as an alternate team member, providing warnings and checkpoints for accuracy.
New approaches
“We are challenged daily with the task of minimizing our errors to decrease claim denials and increase revenue,” reports Hill. The ED made these changes to improve accuracy:
• New staff are required to complete training in the department’s electronic medical record system before receiving a system log on.
• New staff members continue their education by shadowing a preceptor or supervisor for a two-week period.
• Once on-the-job training commences, an assessment is provided.
“The new team member must master all emergency department functionalities before actively registering a patient,” says Hill.
Hill uses registration audit reports to examine revenue collections and insurance claims, to show her registrars the cost of denials. “When errors are created, our leadership team investigates and locates the source,” she says. “We then educate the staff on the incorrect and correct actions for performance improvement.”
As a new manager in the emergency department (ED) setting, Shante R. Hill, manager of the patient access revenue cycle at University of Mississippi Medical Center, Jackson, discovered some unique challenges with registration accuracy.Subscribe Now for Access
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