Are you looking for a way to improve patient registration accuracy for cleaner billing? Here are some practical tools that can help you set up or improve your manual quality assurance (QA) process to be more thorough and consistent across all patient registration locations.
Registration QA Daily Checklist
By using the registration accuracy daily checklist, registration QA reviewers have the ability to record errors found during a manual review process. The checklist standardizes each account review to audit for critical patient, guarantor, and insurance information and other information. The checklist contains 32 of the most common registration errors that affect payment and cause patient financial services rework. The reviewer can record each error type made per account and then make corrections or report the checklist back to the registrar for self-correction. View the checklist.
Registration QA Monthly Tally Form
Data from the daily checklist can then be incorporated into the one-page patient registration QA monthly tally form.
QA reviewers can use the monthly tally form to track each employee's errors in a one-page summary for the month (or any time period that you specify). The tool also allows for calculation of error rate and accuracy rate. The error rate is a ratio of total errors made to total registrations, which factors in multiple errors made per account. The accuracy rate is a ratio of error-free accounts to total registrations. These two metrics are important to understand and are useful for different purposes.
For example, Jane Smith may have an error rate of 20 percent (reflecting multiple errors per reviewed account) but may have an accuracy rate of 90 percent, meaning 90 percent of her reviewed accounts were error-free. One rate is helpful for management; the other may be more appropriate to share with the employee. The monthly tally list can simplify reporting each registrar's productivity, accuracy, and error rates and provides an objective and consistent basis for registrar follow-up, goal-setting, incentives, and performance evaluations.
QA ROI Calculator
The manual QA ROI calculator is designed to help CFOs and financial managers estimate the cost-benefit ratio of setting up a manual QA process, relative to the depth of audit desired. It allows users to enter their facility's statistics, the percentage of accounts they want to review, and the number of error types to audit for the chosen depth of audit. The FTE investment required is calculated on the basis of assumptions provided. The second half of the calculator estimates the potential insurance denials avoided by performing that depth of registration QA. Download the ROI calculator.
Paul Shorrosh is CEO, AccuReg Software, Mobile, Ala., and a member of HFMA's Alabama Chapter (firstname.lastname@example.org).
Linda Sullivan is vice president, AccuReg Software, Mobile, Ala. (email@example.com).
Publication Date: Sunday, June 01, 2008