Patient Registration to Improve the Revenue Cycle

Patient registration is often undervalued in the success of the revenue cycle process.

By: Samantha Geroli, Mindy Singer and Donna Tarsa 

Cash collections are a critical component of the revenue cycle process. Confirming accurately captured and entered charges and timely submission of claims is essential to cash collections.  While collections are important, it is often overlooked that the success of the revenue cycle starts with patient registration.  Accurately registering patients can radically decrease claim rejections and denials, serving the entire revenue cycle with increased efficiencies and bandwidth. Not only will this boost clean claims, but it will also increase the payment rate.

How is Patient Registration Information Obtained?

It is hard to believe that something as simple as how patient information is collected can so substantially change cash collections.  For example, when patients are asked generic questions at the time of patient registration, the error rate will increase.

Don’t Ask:

• Mr. Smith is your insurance the same?
• Mr. Smith is your address the same?

If a change has occurred, the patient will likely assume that the correct information is on file.

Rather, the patient registration team should be trained to ask specific questions!

Do Ask:

• “Mr. Smith, do you still reside at 123 Cole Street?” or
• “Mr. Smith what is your address?”
• “Mr. Smith is Anthem still your primary insurer?” or
• “Mr. Smith what is your primary insurance? ”

These direct questions engage the patient and confirm their information is truly correct. Asking more specific questions will not take additional time, but ensuring accurate information will improve the entire revenue cycle.

Confirm Information

Confirming the correct spelling of names and date of birth again help decrease the error rate. Two easy steps in training patient registration around accuracy is to:

1. Obtain a photocopy of the patient’s insurance card(s) and governmental ID. This also ensures that there is no missing or incorrect information.
2. Confirm the information received is correct by running an eligibility check. This will confirm the patient’s coverage and confirm the information matches what the insurance company has on file. Running an eligibility check is a great fail safe to ensure accurate patient identification along with accurate, real-time deductible, co-insurances and co-payment amounts. This also serves a very important need to confirm the reason for visit is correct. Patients often have more than one chief complaint. Check to see if the patient is attempting to be seen for accident/work related condition as many times these injuries require additional information to be provided. These steps are not only important for the collections process, but crucial to ensure the patient is well informed, bringing higher quality care to the patient.

Check Precertification/ Referral Requirements

Correct procedure and diagnosis information being provided to registration staff is essential. This allows team members to check precertification/referral requirements. If a precertification/ referral is required, steps can be taken to ensure the authorization is obtained. This will decrease the number of denials received for missing authorization. Also, providing the correct procedure and diagnosis information allows the registrars to provide accurate estimates which can result in increased up-front collections.

Training is Essential

Because the patient registration component is typically understaffed, ongoing training and acknowledgement for met goals is sometimes overlooked.  It is important that this team sets both training and outcome goals.  Incorporating these changes into the recurring training of this team will increase collections, improve the clean claims and payment rates, and decrease denied and rejected claims.   Simple, but attractive, cheat sheets should be provided at all team members workstations to help remind them of these areas that can radically improve the overall clinical and financial process.

The Future of Patient Registration

Accurate patient registration is key to a smooth and successful revenue cycle process.  More and more facilities and physicians are utilizing online patient registration which improves the completion of correct information.  As technologies improve and interoperability becomes a reality, the patient registration process with become a much smoother process.