Revenue Cycle

Four days and off you go: Day 1

Patient Access Weekly Advisor, March 17, 2010

Editor’s note: The following is the first of a four-week look into the training program for registrars at Boca Raton (FL) Community Hospital. The patient access department at Boca Raton breaks down the four-day training program into categories and subcategories and sets goals regarding how long each training module should take.

Day one. The opening half hour of day one is devoted to a summary of HIPAA. Management teaches staff members the various acronyms and discusses the dos and don’ts that could spell trouble in terms of HIPAA compliance.

During the following 30 minutes, managers give an introduction to EMTALA. Boca Raton management talks about the delay-of-care issue versus financial obligations that must be met.

After EMTALA comes a two-hour block on Boca Raton’s “pyramid of priorities.” Topics include how to determine coordination of benefits and application toinsurance listings. Boca Raton uses the pyramid to help registrars understand how the registration process works as a whole. The pyramid is included in a PowerPoint presentation that managers give to new registrars.

Next, in a four-hour session, managers go through the basics of the McKesson software system used at Boca Raton, which covers topics such as:

  • MPI search
  • Patient information
  • Guarantor information
  • Next of kin/emergency contact
  • Medical page
  • Physician page
  • Insurance page
  • Insurance verification/approval/authorization page
  • Miscellaneous information page (occurrence codes)
  • Account number assignment
  • Print options

In the final four hours of the day, staff members receive an introduction to managed care insurance. They are taught how to determine whether a patient has regular Blue Cross insurance, the difference between a PPO and an HMO, and other topics, including:

  • Insurance master basics
  • Matching insurance cards to plan codes
  • Correct coding of third-party insurance carriers

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