Wiki Admissions Dept. Errors

[SSummCCH]

Hello. I need some guidance. We are a 25 bed CAH. I am the Revenue Cycle Director and am recently in charge of the Admissions Dept. They make a lot of errors. They do not always check eligibility, they will put in incorrect insurance or old insurance, they will get names wrong and policy numbers wrong, etc. It is not for lack of people in the department. In my opinion, they are overstaffed. But, here is my question - how does your facility handle these situations? Do you send the accounts back to admissions for them to correct or does the billing department just correct the errors or update the information and move on?
Thank you in advance for your advice.

 

[sls314]

Hello. I need some guidance. We are a 25 bed CAH. I am the Revenue Cycle Director and am recently in charge of the Admissions Dept. They make a lot of errors. They do not always check eligibility, they will put in incorrect insurance or old insurance, they will get names wrong and policy numbers wrong, etc. It is not for lack of people in the department. In my opinion, they are overstaffed. But, here is my question - how does your facility handle these situations? Do you send the accounts back to admissions for them to correct or does the billing department just correct the errors or update the information and move on?
Thank you in advance for your advice.

When I worked hospital follow-up, we fixed the registration errors ourselves. It was crucial to make sure that the record was fixed correctly and timely to get the record moving - sending it back to registration to fix just delayed the process. It was more efficient to correct the information while we were already in the patient record working the claim rejection or denial.

As part of our process, we added a tracking code on the account so management could run reports tracking the volume and pattern of registration errors.

The registration manager used the reports for training and development.

I would evaluate to make sure that the staff has the tools they need to do the job properly. What type of eligibility verification applications are being used? Does registration staff have resource lists and sample ID cards from your top payers? Do they understand the impact that registration errors have on the revenue cycle? I'd dig down and see if there were policy & procedure changes that could be implemented to reduce the error rate.

Once the proper tools and training are in place then I think it would be time for performance improvement plans up to the possibility of disciplinary action. At some point, if a person makes the same careless mistakes over and over, they may not be the right person for the position & should part ways. (Again, assuming that they have been properly trained & have the proper tools to do the job.)