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Don't let staff settle for misleading copay data
If some particularly dismal copay collection data came to your attention, chances are you'd want to scrutinize it carefully before presenting this to senior leaders.
At Cincinnati (OH) Children's Hospital Medical Center, the patient access and outpatient preregistration department is working with the hospital's Information Services (IS) department to automate its co-pay auditing processes, says Michelle C. Gray, MHA, director.
"Technology, in general, has helped us work smarter," says Gray. "We are constantly stretching our imagination and working collaboratively with our IS department to get the best results from our systems."
With the new co-pay auditing process, Gray expects to see increased copay collection rates and the ability to provide more accurate co-pay collection rates to senior level executives.
Although outpatient areas are considered to be centralized registration, there also are some decentralized registration areas, notes Gray.
"In the centralized areas, we have always audited copays," she says.
In 2010, one of the decentralized areas presented its copay percentage during a presentation to senior leadership. "It wasn't very high, and so, our new CEO/president wasn't very happy with that. They knew we could do better," Gray recalls. "What came out of this meeting was an intense, hospitalwide focus on copay collection."
The presentation "kind of lit a fire under all of us," says Gray. "Before, it was an area that really wasn't discussed. It became a topic that was on everybody's top list to look at and do a better job at."
Concerns about data
Patient access leaders were skeptical about the accuracy of the department's copay data, because it seemed very low compared to what was being collected in centralized registration areas, Gray reports. Those areas audited copays daily, she says.
"Our numbers weren't close to theirs at all. We started to question, just how accurate is this data?" says Gray. "Our copay collection rate was being rolled into everyone else's."
Gray and her colleagues set out to work with the department that generated the original report to develop a more accurate copay report to distribute to senior level executives. An auditing tool was developed that every registration department could use, Gray says. "Once we start to generate the data, we can see which departments are low. We can put some strategies in place to help those departments raise their copay collection," she says.
The hospital's internal auditing department is in the process of contacting other hospitals to identify an acceptable copay collection rate, so that the hospital can compare itself with others, adds Gray. "We tried to take how we audit on paper and to automate it in the system," she says. "This new auditing process, even though it's not perfect, it's probably about as good as it's going to get."
Gray says that when the summary report is complete, the percentage might be the same or higher, "but at least we will know that it is pretty accurate."
For more information on copay collection data, contact:
Michelle C. Gray, MHA, Director, Patient Access/Outpatient Registration, Cincinnati (OH) Children's Hospital Medical Center. Phone: (513) 636-1414. Fax: (513) 636-7531. E-mail: firstname.lastname@example.org.