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Education became passion for access professional
Requiring CHAM 'would be ideal'
When Elizabeth Reason, MBA, CHAM, agreed a couple of years ago to fill a vacancy on the board of the Michigan Alliance of Healthcare Access Professionals (MAHAP), it was the beginning of a personal crusade for better education and credentialing of access professionals.
"Because I am an educator, I volunteered for [education chair]," says Reason, who is an adjunct faculty member at Davenport University's Lansing campus in addition to being assistant manager for patient access at Ingham Regional Medical Center (IRMC).
In the past, MAHAP's education chair had been responsible primarily for making sure CEUs were done, she notes. But Reason had something more ambitious in mind. "I have always been a very firm believer in personal education for the access field."
She began promoting attainment of the Certified Healthcare Access Manager (CHAM) credential, which she'd like to be a requirement for all patient access managers, Reason says. At MAHAP's fall 2006 conference, she adds, she did a three-hour prep session for 12 members who are now on target to take the CHAM exam in the fall of 2007.
"From a professional standpoint, I think requiring the CHAM for all patient access managers would be ideal," Reason says. "If not required it should at least be encouraged. The CHAM is proof that the manager has met a standard of excellence."
The MAHAP session she conducted focused on "the natural knowledge we have and how to break down a study guide," Reason notes, "but I also talked a lot about study skills and test preparation. Most [access professionals] haven't taken a test in years."
Most of the students in the allied health classes she teaches at Davenport are more than 35, she adds, "and I see a lot of test anxiety in the non-traditional student — those who are not in the 18-24 age range."
Most of the access staff at IRMC are also older and have been with the hospital a long time, Reason notes, so what she's observed from teaching non-traditional students at the university has helped her meet the needs of her own employees.
As well as being "an important distinction for access managers and supervisors," acquiring the CHAM credential sets a good example for staff members," Reason says. "The CHAA [Certified Healthcare Access Associate] is just as important, because the people on the front line are professionals as well. Building the exam into a career ladder requirement is a great way to encourage growth and a standard of excellence."
Her focus in the session at the MAHAP conference, and at a recent presentation to the Association of Illinois Patient Access Management, is on promoting access education and encouraging participants to take the message back to the directors and administration at their individual hospitals, she says. "We have to sell this because education costs money."
At her facility, instituting the CHAA credential as a requirement would have to go through the union to which frontline staff belong, Reason notes. "As a management team, our wish is to have the CHAA exam [required] but I can't guarantee it will get into the [union] negotiations this summer."
In the meantime, the department leadership "will still make a huge push on education" so that employees will be successful if they are in a position to take the exam, she says.
Her assumption, Reason says, is that there will be a pay raise for staff if the CHAA does become a requirement. Access employees at IRMC are already being paid better than in the past, she notes, with a significant increase in the past year.
"They got bumped up a pay grade, and the scale went up," Reason says. "In 2004, the pay range was $10.84 to $13.54, and as of October 2006 it's $12.06 to $15.70."
Comprehensive training implemented
As part of the push toward a better prepared, more professional access department, the scope of Reason's duties was changed in the summer of 2006 so that she could do not only comprehensive education for new hires, but also re-education of existing employees, she says. "We have implemented a retraining program with specific topics."
In addition, Reason notes, she has started a more comprehensive auditing program to provide feedback to existing staff and to the organization's leadership. She also supervises the patient account representatives who do insurance authorization and verification.
After talking about a new access education model for the past several years, and actually putting it together for the past two years, Reason and her boss, the manager of patient access, put the program for new hires into effect on April 2, 2007.
When she joined the patient access department four years ago, there was minimal training on the actual registration and admission process, Reason notes. New employees worked with a trainer for just a few hours before being "pushed out to the front," she says.
Under the newly implemented training program, access employees get 116 hours of classroom and on-the-job training, which is broken down as follows.
The classroom sessions include, among other things, comprehensive training on the admission/discharge/transfer (ADT) system, including "all of the accesses and how to register every patient;" Advance Beneficiary Notice (ABN) training; and instruction in compliance, including consent and authorization, HIPAA regulations, patient rights and responsibilities, advance directives and opting out of the facility directory.
When she entered the access field at St. Joseph Mercy Health System in Ann Arbor, Reason says, she was trained on a very similar model. "I don't feel I would be nearly as successful now if I had not had that training.
"Education is a process, and an ongoing process," she adds. "It never ends. That's how we really approach this. What we have now will evolve even more. We really want to invest in our employees."
(Editor's note: Elizabeth Reason can be reached at firstname.lastname@example.org.)