Hospital sees many changes for access in short time

Patient access staff at Phoenix Children's Hospital have experienced all of these changes in the department in the past few years, reports Irma Becker, manager of patient access:

• A self sign-in system is used, which allows patients to update their own demographics.

"This system enhances wait times and customer satisfaction at the time of arrival," says Becker.

• Account creation and registration are automated.

"Due to our being a hospital-based facility, dual registration was needed on the physician side," says Becker. "The clinic facility account is now auto-created, so the registrar is dealing with only one account."

• Staff pre-register 100% of patients.

"We have a pre-access team in place that verifies eligibility, benefits, demographic information, and liability prior to patients arriving," says Becker.

• Staff members are responsible for giving patient estimates using a newly implemented electronic tool and collecting copays upfront.

On the first visit, registrars discuss deposit amounts. If the patients say they're unable to pay, staff members provide them with applications for the state's Medicaid program and information on commercial insurances.

"We operate on the premise that people want to pay their bills," says Becker. "Individuals who are hesitant about providing financial data usually end up in bad debt because they were non-compliant with our financial assistance policy."

If the patient is uninsured, registrars review the admitting diagnosis, determine a treatment plan with case management, and then schedule an appointment with the parent. If the patient has commercial insurance, the counselor reviews the parent's benefits and determines what the parent's estimated financial liability will be for the admission.

"An appointment is then scheduled to explain the parent's benefits to them, and a request for payment is made," says Becker. "With this approach, we have been able to decrease bad debt and increase up-front collections considerably."

• New locations were added, including satellite clinics.

"The satellites provide specialty services during the day and revert to urgent care status in the evening," says Becker.