Patients benefit from teamwork

Improve communication with clinical areas

It was no secret that clinical areas didn’t have a good working relationship with registrars at OSF Healthcare in Peoria, IL. In 2013, patient access leaders set out to change this relationship.

“They weren’t communicating together in an efficient manner. In some instances when they did communicate, it wasn’t always in a positive manner,” says Jacqueline Doerman, patient access services manager for the health care system’s Patient Accounts & Access Center.

Managers in patient access and clinical areas were continually hearing complaints from their staff. “Both patient access and clinical management got together to brainstorm different ideas on how this could be improved,” says Doerman. “We did not want to create a culture where it was an ‘us-versus-them’ mentality.”

Meet with clinical team

Patient access and clinical management held several lunch sessions recently to improve relationships.

“Each manager brought a small group of staff together so they could ask questions and bounce ideas off one another,” says Doerman. “We are working on initiatives that bring our staff together.”

For example, managers are setting up events during breaks and lunches to get registrars and members of the clinical staff to interact on a more personal level. “The relationships are improving,” she reports. “It is a work in progress, but we have seen improvement.”

Patient access and ambulatory clinical management also have a standing meeting once a month. “Our management meetings allow us to let each other know what is working or if we are having any issues,” says Doerman. “The issues that we have vary each month. We discuss things that are going well, as well as areas that could use improvement.”

During a recent meeting, managers discussed the fact that scheduling is no longer going to be available as a resource on Saturdays. Because outpatient testing is open only from 8 a.m. to noon, staff were concerned about what to do if they need clarification on orders. There is no current process to page a doctor for clarification if the scheduling department is closed.

“The resolution to this is it will just be a pilot closure for now. We will see the issues that arise and whether it is necessary to keep scheduling open on Saturdays in the future,” says Doerman.

Educate clinicians

Because each patient’s encounter starts with a physician’s order, it is imperative that good communication between providers and patient access starts at this point, underscores Dee Alugbin, manager of patient access at Longmont (CO) United Hospital. Clinicians work with registration to ensure that missing patient orders are delivered prior to patient arrival, which facilitates an accurate and timely registration, she says.

In addition, patient access educates clinical staff on the need to have a compliant order and a medically necessary procedure. “We explain the benefit of medical necessity to the patient’s financial health and direct them to the [Centers for Medicare & Medicaid] website for additional information,” says Alugbin. Staff are directed to a booklet that provides information on Medicare requirements for Advance Beneficiary Notice of Noncoverage (ABN) at

Alugbin meets regularly with utilization review nurses to identify reasons for claim denials. Recently, they discovered that financial counselors were using payers’ notification phone numbers, when a different phone number was available specifically for clinical follow-up in order to obtain approval for admission days.

“Our financial counselors now ask payers for this information and document it where it is easily accessible by our nurses,” says Alugbin. “This simple change eliminated the long wait time for our nurses and ensured that clinicals were called in to the right person and location.”


For more information on improving relationships with clinical areas, contact:

Dee Alugbin, Manager, Patient Access, Longmont (CO) United Hospital. Phone: (303) 678-4937. Fax: (303) 678-4966. Email:

Jacqueline Doerman, Patient Access Services Manager, Patient Accounts & Access Center, OSF Healthcare, Peoria, IL. Phone: (309) 683-6765. Fax: (309) 683-6792. Email:

Linda Swanson, Registration Coordinator, Mercy Medical Center, Oshkosh, WI. Phone: (920) 223-1890. Fax: (920) 223-1807. E-mail:

Nikki Taylor, Assistant Director, Patient Access Services/Patient Accounts, Georgia Regents Medical Center, Augusta. Phone: (706) 721-8001. Fax: (706) 721-1818. Email: