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North Colorado Medical Center Redesigns Registration & Insurance Verification Process, Reduces Errors and Increases Revenue | North Colorado Medical Center learned practices of other HMC Partners via the HMC KnowledgeWeb, enabling them to increase revenue, decrease errors, and increase support training, by moving staff into auditing roles. | | Joanne Kinsman, North Colorado Medical Center, explains how NCMC achieved this success. |  | What challenge did you face or what process did you change?
We recently went through a redesign of our registration and insurance verification team, rewriting role summaries to more clearly identify the role of the insurance verification specialist and registrar. This enabled us to combine functions under insurance verification and follow-up.
| | Who was involved in the improvement/change process?
The management team and Supervisors were involved in rewriting the role summaries to create a career path for our staff. We then had them re-graded and were pleasantly surprised that both role summaries were evaluated at a higher grade. | | What improvements occurred?
- Streamlined processes to increase productivity and efficiency.
- Decreased duplication and redundancy.
- Clear expectations were set and everyone held accountable to the same standards.
- Increased customer satisfaction for internal and external customers.
- Advancement opportunities for our staff.
- Clearly identified essential functions of the job by writing a role summary for insurance verification and follow-up.
- Reduced turnover in the department.
- Reduced unbilled from $1.6M to less than $30,000 within one week’s time. We are maintaining that level on a consistent basis at this time.
- Peace of mind that the patient was taken care of from registration to completion of insurance verification and authorization of services.
| | What is the estimate of costs, FTE's, time, etc., saved?
We didn't change FTE ratios; however, reassigned staff to other essential roles in the department. We were able to move two staff into auditing roles. This has helped tremendously in reducing errors, increasing revenue and assisting with training of staff in the departments. | | How was HMC Benchmark data or KnowledgeWeb helpful in your improvement?
We tried out practices from other HMC Partners that we learned from the HMC KnowledgeWeb and HMC Partner networking. | | What will you do differently next time?
We needed to set up tools and action plans as to how we were going to measure our success. We are now monitoring the following and will report back to staff on a monthly basis:
- No-authorization claims at time of registration
- Insurance updates made after the fact for scheduled patients
- Time studies should reflect reduced registration wait times as eligibility, benefits and authorizations should have been completed on all scheduled patients. ABN’s would have also been completed prior to service
- Unbilled report – reduction of claims pending
- UB Edit Error Report - weekly report showing marked improvement
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