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How one facility turned to automated QA and dramatically reversed its error rates

Patient Access Weekly Advisor, August 29, 2007

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As a newly installed business office director at a 250-bed hospital with decentralized registration, Paul Shorrosh, MSW, MBA, and President of Data Solutions, Inc., says he was astounded by the number of complaints he got each week from billing, collections, health information management, and even IT departments, all pointing to data quality errors that the patient registration department made.

To address the problem, Shorrosh began by polling counterparts at other hospitals who also review random accounts manually, and found that the best programs had full-time staff dedicated to manual quality review, but that those programs were limited to random accounts, reviewer subjectivity, and inconsistencies.

After months of testing, Shorrosh and his team finally developed a model that automatically identified 15 common registration errors and reported them back to each patient access employee for self-correction. It was easy to use, and registrars immediately began self-correcting their errors prior to bill-drop.

The hospital watched error rates drop from 35% to 10% in the first six months. That year, they hit the lowest accounts receivable days in five years, and denials dropped by 20%. Their clean claim rate was higher, and the number of complaints from other departments decreased dramatically. Shorrosh reports that the patient access manager and supervisors recovered three to four hours per day previously spent on manual quality assurance (QA) to manage processes and train employees more effectively. Patient access employees appreciated being able to learn about and correct their own errors before anyone downstream had a chance to complain. Soon the patient access staff members began competing to see who could have the lowest error rate in the department and who was registering the most patients per day.

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