Realizing that data integrity and patient information accuracy are crucial to proper payment, Texas Health Resources reduced its duplicate patient records by 21 percent to achieve cleaner claims and faster cash flow. Here are five ways the 13-hospital system met this challenge.


Scrubbing the master patient index (MPI). A thorough, initial scrubbing of the existing MPI enabled Texas Health to identify how many duplicates existed and the process defects that led to their creation. The availability of data that document root causes of duplicates makes it easier to correct improper registration habits. Texas Health was able to use detailed information about what was happening—as well as where and how often—in developing overall communications, education, and training programs for registration and medical records staff. The organization understood that fixing a problem at registration saves considerable time and cost later in the revenue cycle.

Identifying and selecting the right patient records. Advanced probabilistic matching tools were incorporated into the patient record’s “search and selection” process to help registration and scheduling staff easily identify and select the right patient records. These tools can help ensure search results are sorted based on the likelihood that the records match. The results are presented in a ranked and color-coded display so that staff need only review the top choices and select the correct patient record. 

Investing in technology that provides continuous monitoring and staff support. Texas Health invested in technology that improves the process of merging duplicate records to save time when records were inadvertently duplicated.

Educating key stakeholders. Key staff members in both the registration and medical records departments were educated about issues related to duplicate records, the new system, and the steps needed to avoid duplicate creation. Staff education sessions were launched, with special emphasis given to the importance of using full, legal names. The education sessions provided strategies for minimizing patient wait times to keep satisfaction scores high and meet productivity goals. They also focused on how duplicate records affect other areas.

Monitoring performance. Data integrity teams were established to monitor records, identify trends that require re-education, and provide real-time support to registration staff when they encounter problems. Texas Health recognized that ongoing maintenance of a clean MPI promotes patient record accuracy levels that translate to cleaner claims and faster cash flow.

Texas Health has surpassed its initial goal of achieving a duplicate record rate of 0.9 percent or less; the actual rate has fallen to 0.36 percent since 2006. The low duplicate record rate has contributed to a decrease in the number of accounts receivable days—from about 48 in 2006 to 38 in 2012. And the enhanced patient safety resulting from a decrease in duplicate records has allowed Texas Health to move to a single electronic health record platform with clean data that help ensures the validity of each patient’s medical record. 

For more information, read "Minimizing Duplicate Patient Records to Maximize Cash Flow" in the May 2013 issue of HFMA’s newsletter Revenue Cycle Strategist

Patricia Consolver, CHAM, is corporate director of patient access, Texas Health Resources, Arlington, Texas, and a member of HFMA’s Lone Star Chapter.

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