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Sick, upset, and distracted patients often gave inaccurate or incomplete information to registration staff in the ED at Bronson Methodist Hospital in Kalamazoo, MI, notes Tina Nadrasik, the department's Patient Access manager. This problem sometimes resulted in claims denials, she adds.
ED registration staff now use a new process to obtain demographic or insurance information from admitted patients, says Nadrasik. If a patient is going to be admitted from the ED, a verification staff person doesn't ask for this information while he or she is still in the hectic, noisy ED, she explains. Instead, the staff person waits until the patient is up on the floor in a room to review the information, she says.
"We talk to them in an environment that is more patient-centered and more relaxed than the ED," says Nadrasik.
Patients are more likely to listen carefully to the questions from the staff and to correct outdated addresses or telephone numbers, says Nadrasik. "In the ED environment, we don't always get that," she says. "The focus is more on the patient's medical needs."
A pilot was done in ED registration for 30 days, using the new process. "We found that we got better information," reports Nadrasik. "By the time they have gotten to the room, patients are more informed of what is happening to them."
For example, ED patients sometimes had Medicare as secondary payer insurance, and this information often wasn't being captured, says Nadrasik. "A lot of times, all the patient would tell us in the ED was that they had Medicare," she says. "Once they got up to a room, they would tell us, 'By the way, I have this too.'"
Often, registrars are able to obtain important details or make necessary corrections just because patients are calmer and not in pain, Nadrasik says. "During the pilot, we were able to make corrections to a piece of the demographic information on 18% of admissions," she reports. "It wasn't always the wrong insurance it may have just been a cell phone number but that information is important for follow-up."
In the ED's previous process, says Nadrasik, a single person performed all of the verifications.
"She did all the direct admits and all of the admits from the ED," she says.
The verification person was swamped with work on Mondays because of all the admits over the weekend and would spend the rest of the week trying to catch up, says Nadrasik. A verification team was created to perform real-time verification of data, she says.
"Having a second person in there doing real-time verifications really helped," she says.
For more information on ED registration processes, contact:
Tina Nadrasik, Patient Access Manager, Emergency Department, Bronson Methodist Hospital, Kalamazoo, MI. Phone: (269) 341-8935. E-mail: email@example.com.