Train staff in these 3 skills

The single biggest challenge for registrars is all the multi-tasking they need to do, according to Cynthia Norman-Bey, director of patient access services and the PBX (private branch exchange) Call Center at Glendale Adventist Medical Center.

"Tasks are all equally important, and all require that courtesy of services remains a primary focus," Norman-Bey says. Here are three key areas to focus training on:

• The assertiveness required to obtain authorizations.

At OSF Healthcare System in Peoria, IL, staff members struggle with being assertive enough to deal with "push back" from insurance companies and physicians in order to put the necessary authorizations in place, says Luka Krietemeyer, patient access services manager of the financial Clearance Center/Patient Accounting and Access Center.

"It is a delicate dance at times, to make sure all three entities are on the same page," Krietemeyer says. "All of the appropriate requirements need to be met, to optimize patient coverage and reimbursement."

• Familiarity with new terminology.

New patient access hires will need to become familiar with the meaning of dozens of terms used for authorizations and benefits, such as "precertification," "referral," "Radiology Quality Initiative," and CPT codes, says Krietemeyer. "This is a struggle for some staff initially," she adds. "But as they work the same types of appointments repeatedly, the terms start to become part of their normal process."

• New processes for obtaining consent for treatment.

Registrars at BayCare Health System in Tampa, FL, recently had to become accustomed to a new process involving consent for treatment. Every patient, with the exception of pediatric and psychiatric patients, now has the option to sign a consent for treatment during each visit, or they can choose to have a "lifetime consent" on file, says Tammy A. Scott, CHAM, a patient access service manager in the Emergency Center.

However, in order for the signed consent to follow the patient throughout any of the health system's inpatient or outpatient facilities, it needs to be electronically signed and stored at the Corporate Identifier Number level. "It is not uncommon that during a registration, the registrars must place some signatures in multiple folders within our electronic scanning system," says Scott.

Most patients choose to sign the lifetime consent, which requires the registrar to store the electronic signature differently, she adds. "This new initiative was a major change to the workflow process that the registrars previously used," says Scott. "Until now, all electronic signatures received were stored at the visit level." These steps were taken to train staff:

• Registrars attended a mandatory webinar on the new process.

• Trainers, managers, and registration coordinators watched the registrars complete registrations.

"They made sure they had a full understanding not only of which forms go into which file, but also the importance of why the consent needs to be separate," says Scott.

• All registrations were audited.

"We reported all of the errors for this new process," says Scott. "We could see exactly who needed more time with a trainer, manager, or peer."