Revenue Cycle

Tip: Smoothing wrinkles in preregistration

Patient Financial Services Weekly Advisor, June 25, 2004

Preregistration has a wide array of definitions, varying from simply having an account number to a complete registration that includes demographics, insurance, visit, medical necessity, eligibility, benefit information, and point-of-service collection attempts.

In our facility, preregistration means that the only thing a patient must do upon arrival is sign a consent and go to the clinical area for service. That means we've gathered a complete set of demographics, insurance info, and visit info. We've verified eligibility, checked for authorization requirements, obtained benefit information, and attempted to collect at the point-of-service if a patient owes. I believe that anything short of this does not deliver the value that the patient, physician, or hospital needs in order to compete in the outpatient market.

Setting a goal for how many of your patients should be preregistered is difficult. It's complicated because of add ons and low-dollar, high-volume service lines (such as mammography). Our experience has led us to measure preregistrations as a percentage of scheduled patients. Our service level commitment is that we will preregister 80% of our patients who are scheduled by 1 p.m. the day before the scheduled procedure or test.

In working toward this target, you will need most-if not all-of the following:

  • A PFS/patient access leadership commitment to reach these targets.
  • A great working relationship with scheduling. Our preregistration and scheduling departments share a manager and work in the same office space. They report to the patient access manager, who reports to the PFS director.
  • A resource-based scheduling module that captures all scheduled business.
  • Automated eligibility and benefit checking capability-especially for Medicare and high-volume managed care payers.
  • Computer-based fax image capture of written physician orders. Our facility uses a system that captures all incoming faxes and then distributes them to the various registration departments. This software is controlled in scheduling.
  • A lot of hard work.

    Reaching these targets has enabled our registration department to significantly decrease wait times, increase patient satisfaction, and increase productivity in our registration areas. Your facility will benefit greatly for the work that you put into this project.

    This question was answered by Daniel Wolcott, MBA, director of patient financial services, Florida Hospital Memorial Division.

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