Most patient access managers that I talk to want their registrars to score 100% accuracy, 100% of the time. Some of my favorite calls are from customers who want to know why their final accuracy score is 99.7% instead of 100% and often times I tell them, “you may be missing the point,” (pun intended.) There are several scenarios Patient Access Managers should review if they are consistently hitting above 95% in any accuracy category on a monthly basis.
1. Check your scope. How many edits are active? Many customers celebrate when they hit 100% (that is until their Client Support Representative calls and suggest adding 10 or 20 new edits). If you are hitting high accuracy marks 100% of the time but only have 30 edits active, you are simply not firing at all available targets.
2. Check your aim. What is your resolution rate? Customers focused and determined on that Final Accuracy Rate can sometimes become obsessed over the wrong numbers. I can have a 90% Initial Accuracy Rate and a 96% final accuracy rate and that looks good on paper. But how many errors did we miss? How much did we actually improve? A resolution rate of 60% leaves a lot of room for improvement – and if the high dollar account errors are in the 40% of the accounts with errors unresolved, the denials may put a downer on any accuracy celebrations.
3. Check your results. One of the most overlooked and underutilized resources for departmental success for many Patient Access Managers may be their counterpart on the billing side of the house. Patient Financial Services and/or Billing Office Supervisors can play a key role in the success of your department and in turn the entire organization benefits. By checking your Front End Accuracy results regularly, you can recruit a specialist who traditionally may have been viewed as a competitive threat into a trusted and valued member of your team. How? Ask your billing office what the top 10 billing denial reasons were for the past 3 months – specifically those that may have been related to front end errors. By identifying which of these denials may have been prevented had they been caught on the front end, you avoid the pitfall of walking into a monthly meeting with 100% accuracy and a denials report that calls that accuracy into question.
Director of Support Client Services