85% to 90% bypass registration
A method for keying ancillary department schedules enables patients at Swedish Covenant Hospital in Chicago to go directly to the point of service (POS) and have any missing pieces of the registration process completed there — unless there’s something unusual that needs to be taken care of in registration.
Either way, says Gillian Cappiello, CHAM, senior director for access services and chief privacy officer, an employee in lobby services directs the arriving patient to the appropriate place, based on a list of scheduled patients, so that there are no unnecessary steps.
To put the process in motion, she explains, the scheduling coordinator who makes the appointment and preregisters the patient enters the appropriate letters — choosing from a list of “Patient Flow Identifiers” created by the access department — in a customer-defined field in the hospital’s Meditech system and gives instructions and directions to the patient. (See Patient Flow Identifiers.)
The flow identifier and the department location print on information desk schedules and the flow identifier prints on department schedules, Cappiello says. For example, if there are no extra steps needed, and the patient is to go directly to the department where service will be rendered, she continues, “POS” appears after the person’s name.
Routinely, the personnel in that department are responsible for getting the consent signed, giving the Joint Notice of Privacy Practice if applicable, and activating the account in the Meditech system by changing “preregistered” to “registered,” Cappiello adds.
If “POSI” appears after the name, the patient also goes directly to the point of service, and personnel there know to make a copy of the individual’s insurance card, she points out. In most cases, registrars can verify the person’s insurance on-line before the appointment, but with certain insurers that isn’t possible, notes Cappiello. “If they have [an insurer] like Private Healthcare Systems, where the address for billing is different across the country, the patient flow identifier might be ‘POSI,’” she adds.
Other abbreviations let staff know that a referral is needed for the appointment, that an Advance Beneficiary Notice (ABN) needs to be issued, and so forth, Cappiello says. “Information desk and department [personnel] know where to direct a patient, as well as if there is anything needed from the patient,” she notes. If there is a “C” after the name, the person at lobby services says, ‘I see that you have an appointment at radiology, but I need you to go first to the cashier,’” Cappiello adds.
For a patient who does need to be seen in registration, the patient flow identifier might be “REG” or “REGC,” she points out. In the latter case, a registrar needs to update all the information, obtain referrals and copies of cards, register the account — and direct the person to the cashier. “We try to make sure our description of the department actually matches what it is,” says Cappiello. “The CT scan is not in the same place as the MRI — there is a ‘RAD-M’ [main] and a ‘RAD-G’ [referring to the name of the other building where radiology is located]. We need to make sure patients don’t get lost,” she explains.
The process, in place since August 1998, “saves a lot of people from coming to registration. We probably have 85% to 90% bypassing registration,” Cappiello adds.