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Q&A on accuracy rates

Patient Access Weekly Advisor, February 27, 2008

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In 2007, the patient access advisor conducted a survey with access professionals about registration accuracy rates. About 75% of respondents said their facility tracks them.

We posed some of the same questions we asked in the survey, along with a few new ones, to Stephanie Smithson, CHAM, patient access manager at Dunn Memorial Hospital in Bedford, IN.

1. If you do track accuracy rates, what approach do you use? We track manually.
2. Do you perform registration audits, and, if so, how often do you perform them? Audits [are] done daily.
3. What are your accuracy rates? Accuracy rates average around 90% for staff here longer than six months. Staff members [who are] here less than six months average 75% accuracy rate.
4. What types of errors are you finding most often? Data entry, incorrect insurance information, incorrect guarantor, incorrect location/type, missing accident information.
5. Who conducts registration training? Registration training is done by the trainee online, and in the training environment, trainers provided the rest of the training real time with patients.
6. What method of training do you use with your registration staff? The method is an online training manual I created, training environment for HIS system, online policy and procedure manual I created, competency exams I created in our hospital education system, [and] training with a trainer with live patients.
7. What is included in your training? Included in training [are] screenshots of how to complete all areas of registration in our HIS system, policy and procedure manual, training checklist, MSP, Medicare, Medicaid, payer tips, where to find information on registration questions, switchboard training, medical necessity checking, [Joint Commission (formerly JCAHO)] hot points for registration, and how to read the insurance cards.
8. How important is it to track accuracy rates? I think it is very important. We have always checked for accuracy, but we did not begin tracking by person until 2006. I began that to show each person the impact they could have as individuals on the accuracy for the department, which in turn has an impact on A/R. I added this to evaluations and open positions to give the staff a personal incentive to achieve the goals we have.

9. How does staff react to the tracking approach? In general, they are positive. Of course, some of the staff do not like to see they have made errors, but it in turn creates discussion about what is incorrect and why. The only negative I have seen is that it does create some tension between the staff who audit and the rest of the staff. [On the third shift, we audit] each day's work and place it on a spreadsheet with the error description by clerk to see trends and areas to concentrate training for each individual. It has also created competition to have the lowest error percentage. The competition gets pretty fierce at times, as this is used for their evaluations, and when open positions and shifts open up, their error percentage, volume of work, and seniority all are considered.

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