New tools needed to staff access — Flex according to volume at any given hour
In the past, the only way for patient access managers to develop productivity standards was through time studies, says Mark Sammartano, interim director of revenue cycle and managed care at Waterbury (CT) Hospital.
"More often than not, staffing was based on a hit-or-mix approach. This is no longer the case," Sammartano says. "Multiple tools exist today that provide management with both quality and quantity measures."
These systems integrate several key tasks: insurance verification, medical necessity screening, address validation, and point-of-service estimates. "At Waterbury Hospital, we are in the process of deploying such a system," says Sammartano. "These tools not only assist with these tasks, but also provide the information interactively."
Reduce delays, denials
Patient access departments at Waterbury Hospital are implementing tools from Plano, TX-based DCS Global.
"We are two weeks into implementation. It will take a month or two to accumulate enough data for analysis," says Sammartano. "However, we can identify performance variations between individuals now."
The goal is to reduce avoidable insurance payment delays and denials, says Sammartano. Staff members achieve this goal by getting accurate and complete information before the patient leaves the registration area and by providing an accurate estimate of the patient’s balance at time of service.
Without this information, he says, patient access leaders must resort to using manual sampling methods that are sometimes outdated or inaccurate. "Errors can be missed, and feedback to staff is haphazard," says Sammartano. New systems provide immediate feedback so corrective action can be taken before an error affects the account.
"Analytics gives management a true picture of capacity, based on objective data that does not require hours of manual review," says Sammartano.
A simple spreadsheet
Patient access leaders at Ochsner Health System in New Orleans developed a simple productivity Excel spreadsheet that uses a blend of recommended productivity key performance indicators (KPIs) from the National Association of Healthcare Access Management (NAHAM) and the Healthcare Financial Management Association (HFMA) for hospital, clinic, and ED registration. [A Sample Patient Access Services Monthly Productivity Log is included with the online issue. For assistance, contact customer service at [email protected] or (800) 688-2421.]
"Because our organization operates some areas differently, we have adjusted these to meet what we feel is our target productivity, based on other KPIs such as QA and first claim payment rate," says Stacy Calvaruso, CHAM, assistant vice president of patient management. "We feel that you must balance quality with quantity."
For example, registrars are also receptionists in some rural clinics, which negatively affects the number of clinic visits per registrar. "Therefore, registrars’ overall previous two-year performance by quarter is evaluated, and targets are adjusted accordingly," says Calvaruso.
