Get staff competent in multiple areas
Staff need wide-ranging skill set
Members of your patient access staff might act as customer service clerks, financial counselors, and patient advocates all within an hour, and they also are tasked with providing accurate directions within the medical center, according to Chris Hatcher, registration manager for Sutter Delta Medical Center in Antioch, CA.
Patient access staff must be well-versed with numerous insurance plans and need a comprehensive understanding of the various plans' contract language and when prior authorizations are required, adds Hatcher.
"I have found more and more insurance companies are doing less in regard to educating patients on the specifics of their health care plans and what may become patients' responsibilities for services rendered," she says. Therefore, says Hatcher, members of the patient access staff have become the point person to explain benefits, co-payments, deductibles, and non-covered services to the patient.
Patient access staff members need expertise in medical terminology, coding, enhanced computer skills, and customer service, adds Hatcher. They manage a "delicate balance" as patient advocates and gatekeepers to the medical facility, she says. "Once a patient clears patient access, many assume all services will be reimbursed and covered," Hatcher explains. "It is imperative that our job include properly informing the patient of potential financial risk."
At St. Joseph's Regional Medical Center/St. Joseph's Wayne Hospital, both in Paterson, NJ, the patient access department consists of the information desk, emergency department registration, outpatient registration, and pre-registration covering the two campuses. "In order to maintain adequate coverage and utilize staff effectively, staff has been cross-trained in the different areas," says Sandra N. Rivera, RN, BSN, CHAM, director of patient access.
Pre-registration staff assist the outpatient area during peak hours, which occur in the morning due to many patients fasting for outpatient lab work. "This helps the outpatient registration area to process the influx of patients and reduce the patient wait times," says Rivera.
During low-volume times in the outpatient area, the department's registration staff assist pre-registration areas in the completion of cases booked for future dates. "This allows the pre-registration staff to concentrate on the insurance verification and authorization component, while the registration staff works patient demographics and advises the patients of their financial responsibility," says Rivera.
Blended approach
Betsy Keating, interim patient access director at Northwest Community Hospital in Arlington Heights, IL, uses a "blended approach" for training, with classroom instruction, computer-based self-learning modules, and hands-on experience. Keating is a senior consulting manager at Chadds Ford, PA-based IMA Consulting, which provides revenue cycle services for the healthcare industry.
Once an employee meets core competencies and demonstrates proficiency in their role, begin cross-training for other access areas, such as admitting and emergency department registration and registration support for freestanding facilities, she advises.
When an access employee learns interview techniques, insurance entry, benefit verification and eligibility, point-of-service collections, and customer service, these skills are carried with them to all access points, says Keating. "Then it is a matter of incorporating the nuances of each area to ensure compliance and optimal workflow," she says. For example, she says, emergency department compliance is unique because it is governed by Emergency Medical Treatment and Labor Act (EMTALA) regulations, while outpatient registration diagnostic areas are subject to Medicare medical necessity and Advance Beneficiary Notice (ABN) compliance.
"A well-trained, high-performing access employee ensures accurate, timely, and efficient registrations through the billing cycle," says Keating.
Sources
For more information on cross-training patient access staff, contact:
Betsy Keating, Interim Patient Access Director, Patient Access Services, Northwest Community Hospital, Arlington Heights, IL. Phone: (847) 618-4595. E-mail: [email protected].
Jamie Kennedy, Supervisor, Patient Access, Ohio State University Medical Center, Columbus. Phone: (614) 688-6316. E-mail: [email protected].
Roxana Newton, Patient Access Supervisor, Porter Adventist Hospital, Denver. Phone: (303) 765-6545. E-mail: [email protected].
Sandra N. Rivera, RN, BSN, CHAM, Director, Patient Access, St. Joseph's Wayne Hospital/St. Joseph's Regional Medical Center, Paterson, NJ. Phone: (973) 754-2206. Fax: (973) 754-4662. E-mail: [email protected].
Members of your patient access staff might act as customer service clerks, financial counselors, and patient advocates all within an hour, and they also are tasked with providing accurate directions within the medical center, according to Chris Hatcher, registration manager for Sutter Delta Medical Center in Antioch, CA.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content. TESTING
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