CHAA Examination PreparationFuture Development – Session II
Pages 113-127University of Mississippi Medical Center
What to Expect…• This module covers various aspects of
Patient Access knowledge found in pages 113-127 of the FUTURE DEVELOPMENT section of the 2010 CHAA Study Guide.
• A quiz at the end will measure your understanding of the content covered.
Staff Education and Competency
• KEY PERFORMANCE INDICATORS (KPIs) are created to help an organization DEFINE and MEASURE progress toward organizational goals.
• They reflect the CRITICAL SUCCESS FACTORS.
• They must be QUANTIFIABLE(measurable).
• Examples: 97% Accuracy Rate, Register X amount of patients per hour, Patient wait times less than X minutes, Point of Service Collections, etc.
Revenue Cycle KPIs• In the past, hospitals focused a majority of
their efforts at the end of the Revenue Cycle.– What is wrong with this process?
• Most revenue cycle problems occur when the hospital is collecting and verifying patient information needed to ensure a clean submission claim and receipt of full payment.– So how would you address this problem?
Performance Improvement Methods
• PROCESS IMPROVEMENT is the act of INCREMENTALLY exceeding the requirements through continual ENHANCEMENTS and REFINEMENTS.
• There are SCIENTIFIC and SYSTEMATIC methods, techniques, and tools used to improve performance.
• Before you conduct process improvement, the OBJECTIVES and OUTCOMES must be MEASURABLE and WELL UNDERSTOOD.
FOCUS - PDCA• The purpose of FOCUS – PDCA is to improve the
product or service from the CUSTOMER’S VIEWPOINT.
F – Find a process improvement opportunityO – Organize a team who understands the processC – Clarify the current knowledge of the processU – Uncover the root cause of the variation or
poor outcomeS – Start the “Plan-Do-Check-Act” Cycle
Six Sigma• Six Sigma is a process improvement
technique using organizational wisdom and statistics to identify and eliminate the “DEFECTS” in a process.
• A “defect” is anything outside of customer expectations.
• It focuses on making sure we’re doing the right things correctly the very first time.
Lean
• Lean and Six Sigma are complimentary in nature.
• Lean focuses on ELIMINATING NON-VALUE ADDED STEPS in a process.
• Lean ensures we are focusing on the RIGHT THINGS.
Process Reengineering• This involves FUNDAMENTAL
RETHINKING and RADICAL REDESIGN of business processes to achieve DRAMATIC improvements.
Changes must be:»Radical»Dramatic»Contemporary
Flowcharts & Process Maps
• A Flowchart is a graphical representation of activities that make up a process.– Steps taken in registering a patient
• A Process Map is a graphical picture of the actual workflow through a company.– This helps clarify who is responsible for a
step or a task in the process
Patient AccessTraining Models
• Hands-On Computer Training
• Formal Classroom Training
• Peer-to-peer training
• Self-paced Training
• Role Playing
• Experiential
• CBT (Computer Based Training)
Patient Access Training Modules
• Computer systems Training
• Customer Service Standards
• Insurance Verification
• Pre-Certification• Calculating Patient
Liability
• Overview of healthcare finance
• Medicare/Medicaid• Managed Care• Revenue Cycle Ops• Medical Terminology• Scheduling• Regulations: HIPPA,
EMTALA, etc.
Competence• Competence is a STANDARDIZED
requirement for an employee to properly perform a specific job.
• It encompasses a combination of skills, knowledge and behavior.
• Two Types of Competencies are:– Behavioral and Technical
Behavioral and Technical Competencies
• BEHAVIORAL COMPETENCIES are learned through life experiences which form our behavior patterns.– The ability to get along with others, adapt, be
a team player, have a positive attitude, maintain composure under pressure, etc.
• TECHNICAL COMPETENCIES are learned in an educational setting or on the job.– Registering, verifying information, calculating
deposits, the ability to read and write, etc.
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