CHAA Examination
Preparation
Future Development – Session II
Pages 113-127
University 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 opportunity
O – Organize a team who understands the process
C – Clarify the current knowledge of the process
U – Uncover the root cause of the variation or
poor outcome
S – 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 Access
Training Models
• Hands-On Computer
Training
• Self-paced Training
• Role Playing
• Formal Classroom
Training
• Experiential
• Peer-to-peer
training
• 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.