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Some patient access leaders are realizing that exemplary staff members can be a major resource for training and education. This could be because staff are more comfortable learning from their colleagues, or because the department is being charged to do "more with less" and more formal training resources are cut. Either way, it can be a successful strategy.
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Next time you get a complaint, don't let it ruin your day. Instead, find a way to make a customer's dissatisfaction work to your advantage.
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To reduce administrative claims denials, Virtua Healthcare System in Marlton, NJ, did two Six Sigma projects. "Our major mission for the first project was to identify root causes that resulted in administrative denials at all campuses and all registration types," says Diane E. Mastalski, CHAA, CHAM, director of patient access.
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Reasons for claims denials often can be traced back to factors beyond patient access, such lack of medical necessity, lack of clinical documentation, or a physician not participating with a plan. This is why "patient access cannot work as a silo in reviewing claim denials," says Carol Triggs, MS, director of patient access at St. Joseph's Hospital Health Center in Syracuse, NY.
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Does a system claim to be the "be all, do all" for your patient access department's issues, such as an eligibility system verifying benefits for all payers? If so, be skeptical.
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If you want to see how satisfied your customers are, some type of survey is probably the tool you rely on. Kathleen Bowles, a hospital admitting supervisor at The Ohio State University Medical Center in Columbus, says that patient satisfaction scores "are a concrete reflection of our efforts, that everyone in the department can understand."
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While you wish that no patient ever had to wait in any registration area, that's not realistic due to patient volumes and other factors beyond the control of your department.
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You may not think of it this way, but your department has a wealth of data that would impress others. Have patient wait times decreased dramatically, have patient complaints become almost non-existent, or have your accuracy rates doubled? Don't resist the urge to brag.
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Patient access staff are the very first contact many patients have with physicians and facilities. Whether staff are registering patients in the emergency department, call center or at the front desk of a physician's office, "this first impression has long-lasting effects," says Colleen McMahon, senior manager of the integrated call center/ University of Pittsburgh Medical Center (UPMC) physician service division, registration and scheduling.
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The role of your patient access staff has undoubtedly changed dramatically and will continue to become more complex. It's likely, though, that the way you evaluate competencies doesn't reflect this evolution.
