annualreport fy2014


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CCHMC Registration Services Annual Report FY14


Page 1: Annualreport fy2014
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Michelle Gray Director 

Amanda Hummeldorf Access Services Manager 

Kelly Hendrix Administra ve Assistant 

Korie King TQCA 

Pa  Stepp Director of Opera ons 

Sherri Kissinger Access Services Manager 

Joe Geers Project Specialist 

Sheila Robinson TQCA 

Pam Dunaway Access Services Manager 

Kelli Knipper Access Services Manager 

Dorris Ball Lead TQCA 

Nancy Becker QCA 

Allene Ford Access Services Manager 

Vicky Robine e Access Services Manager 

Pat Burke TQCA 

Kristy Fazzio QCA 

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Many individuals around Cincinnati Children’s know about the Registration Services Department. You may attend our Outpatient Registration Forums, receive our newsletter, call the registration help desk for assistance, or house some of our registrars in your clinic. We also provide training for new employees on the registration process, as well as updates and refresher training. Our ultimate goal is to provide great customer service!

We have changed the timing of our Year in Review from calendar year to fiscal year, to capture data, events, projects, and statistics in a format that follows many other reports within CCHMC. You may also notice that we changed the format of our Year in Review. We hope our annual report will help give you a glimpse into our accomplishments of the past fiscal year and provide a better understanding of how we work with other departments throughout Cincinnati Children’s to “change the outcome” for our patients and families.

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REGISTRATION ORGANIZATION CHART The chart below displays the structure for patient registration at CCHMC:

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In January 2014, the Outpatient Registration Area for Endocrinology/Diabetes CTRC-DEXA joined Registration Services. This move added 2.7 more FTEs to the Registration Services staff. These ASRs check-in patients for endocrine and diabetes visits and the Clinical Translational Research Center (CTRC) research studies for various principal investigators around the hospital and DEXAs (bone scan) testing. This registration area is located on E-2 at the Main Campus.

On February 17, 2014, the Oncology Hematology Center (OHC) joined Registration Services. This added 2 full-time FTEs and one part-time FTE to the Registration Services staff. These ASRs register lab specimens for adult patients that are delivered from 14 different OHC offices for lab processing. The ASRs also use the CoLab ordering interface to receive test orders from OHC. They also scan/enter the OHC requisition number in CoLab to search for the order that is listed on the requisition. This registration area is located in the Lab on B-4 at the Main Campus.

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BY THE NUMBERS: Fiscal Year 2013-2014 Total Registrations: Base: 249,489 Neighborhood Locations: 372,905 TRC/Lab Specimens: 41,381 The Auditing Team within Registration Services audits ASR registrations for the following items: • Insurance Plan Accuracy • Document Content/Consent Accuracy • Co-Pay Collected • Insurance Card Scan • Co-Pay Reason Accuracy

All of the above categories appear on the ASR scorecard. The bottom chart displays the “Overall Scorecard Average” for the department.

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KIOSK STATS by: Michelle Gray

Unfortunately we have noticed a drop in kiosk utilization over the past year. Constantly we are challenged with incorporating registration requirements into a kiosk registration that we would like to be effortless. During FY14, a Welcome Kiosk Usability Team was formed to address the kiosk “look & feel” in addition to functionality. The overall goal is to improve the kiosk experience for our patients and families.

Our plan for FY15 is to: • Continue review and assessment of kiosk workflows • Review kiosk requests for changes • Determine what changes are the highest priority • Decide what areas the team should work on first • Activate workplan

Members of the group include:

Jason Bayman Julie Bick Anne Boat, MD Beth Moone Anna Diederichs Julia Elkus Michelle Gray Tammy Hatcher Jason Napora Laurie Perry Rupa Radhakrishnan Dave Seeger Alex Towbin, MD The chart to the right displays the kiosk usage throughout CCHMC.

CCHMC Kiosk U liza on 


on % 

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Registration Services established very aggressive MyChart sign-up and activation goals in FY14; the goal for MyChart sign-ups was 20,000 with MyChart activations of 10,000. We didn’t begin to measure these data until January of 2014, and in six months, we made a difference! This goal supports the organization’s initiative to increase the number of patients that utilize MyChart. MyChart is a mini view of the patient’s electronic medical record. The patient/family no longer has to wait for physicians to call to learn results of important tests ordered by their physicians. They can look them up themselves! Also, this enables the patients/families to communicate with their care teams of physicians in a more efficient and effective way to request information, ask questions, or get refills of medication. We signed up 32,433 of our families to receive this service (exceeding goal by 12,433)! That is just the number of families who said “Yes”. We know there were more conversations with families who chose not to sign-up at this time……and that’s OK! The activation of MyChart accounts proved to be a little more challenging. Registration Services does not have direct impact on the activation piece of this process. The role that we play is to give the family the information required to activate these accounts and to gently remind them at their next visit if the account hasn’t been activated. There were 7,168 families who activated their accounts this year. Our MyChart experts reported that this ratio is among the industry normal. We extend a special “thank you” to Juli Bick and Philip Lucas who support MyChart. They worked diligently this year to streamline this process to make it easier for us to be successful.

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Congratulations to the following ASRs who received their CHAA certification this past fiscal year: • Nancy Becker—Mason • Sherry Beckham—Admitting • Kera Cascadden—Kenwood • Darnesha Coleman-Figgs—Base (Dentistry) • Erin Detjen—Liberty • Stephanie Edwards—Base (Registration Services) • Lindsey McCarthy—College Hill (Speech Pathology) • Cindy Parks—Base (Dentistry) • Kelli Rinear—Base (BMCP) • Jill Scudder—Base (Dermatology) • Toni Thoroughman—Admitting • Robin Vogelsong—Anderson


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The Mission Statement of NAHAM The National Association of Healthcare Access Manage-ment provides quality educational programming and in-teraction for professionals engaged in the management

of patient access services in healthcare delivery.  

NAHAM 41st Annual Meeting

will be held on April 19 - 22, 2015

JW Marriott– Indianapolis, Indiana 

The National Association of Healthcare Access Management (Admitting to Patient Access) celebrated its 40th anniversary at the annual conference held in Hollywood, Florida in May 2014. Michelle Gray, Patti Stepp, and Pam Dunaway represented you and CCHMC at this event.

While at the conference, a significant amount of time was spent learning. There were many learning labs and symposiums. The vendors in our industry, who have innovative approaches to enhancing our work, were there for discussions. Opportunities to network with other Children’s Hospitals and the opportunity to come away with new contacts to compare practices was valuable. Guess what? We share many of the same successes and concerns! We are not alone and have a great pool of resources to collaborate with when questions come up. We also heard from key speakers on topics such as Joint Commission and role definition of an Access Services Representative to name a few. Michelle Gray and Patti Stepp visited our colleagues at Miami Children’s and Joe DiMaggio Children’s at Memorial while we were there. We made note of their patient tracking systems, dress codes, workflows, and shared information about what was working well and how we made improvements to process that impact our work. Since our return, we have sent correspondence back and forth regarding patient tracking, transplant patients, and admission notification.

NAHAM (NATIONAL ASSOCIATION OF HEALTHCARE ACCESS MANAGEMENT) 40th Annual National Conference & Exposition by: Patti Stepp

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How does this benefit CCHMC? We have started looking at the regulatory standards to en-sure that we are in compliance with some of the topics discussed at this conference. A vendor has been on site (Trace) to demonstrate an all-inclusive way to capture documents and communication between CCHMC representatives, patients/families, insurance com-panies, and internal departments. We have reached out to contacts at other facilities to compare practices for obtaining photos, and communicating with insurance companies to more efficiently notify them of admissions. Pam has expressed interest in a learning plan that helps us to develop the future leaders of our department from a learning lab that she attended at the conference. Michelle, Patti, managers, and leads are committed to find-ing ways to make your jobs easier and more efficient while maintaining high levels of com-pliance, customer service, quality, and innovation. Our goal is to continue to look towards best practices for CCHMC Registration Services!

Visit the NAHAM website to obtain

more information 

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C2 Centralized Registration is the newly renovated combined registration area for Audiology, ENT, Gastroenterology (GI), Pediatric Surgery Center, Test Referral Center (TRC-C2) and the Multi-practice Center (MPC). The first phase of the C2 construction started in January, 2014 with the construction of the serpentine shaped 10 station desk. U p o n t h e c o m p l e t i o n o f construction came the moves of the

Pediatric Surgery Center and MPC registrations to their new work stations in mid-March. The second phase in late March came with the moves of the Audiology, ENT and TRC- C2 registrations areas. The final phase was the move of the GI registration completing the moves for this centralization. The design of the C2 waiting areas is decorated with whimsical wall murals providing wayfinding for the five clinical suites: • Suite 1 is the MPC clinics • Suite 2 is the Pediatric Surgery Center • Suite 3 is the Audiology & ENT clinics • Suite 4 is the TRC- C2 • Suite 5 is the Gastro Clinic

The C2 Centralized Registration consists of 10 registration stations. All ten registrars check-in for over 20 multi-discipline subspecialties, including walk-in testing for the laboratory. In order to better facilitate clinic flow, there is a flow controller who addresses concerns presented by patients, parents, and clinical staff.

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Liberty Campus, which opened in August 2008, is already bursting at the seams and an expansion is underway. If any of you have seen the Liberty Campus in the past several weeks, you know there is a significant amount of construction activity occurring. The cranes are tall, and dirt is plentiful! There are 4 major expansion projects happening simultaneously:

1) The Cancer Therapy Center is under construction to the south of the existing building. 2) At the north end of the existing building, there is expansion to all 3 existing floors. This

area will expand clinic space as well as surgery and office space. This will also allow for larger support services such as storeroom/dock and pharmacy.

3) On top of the existing building, a 4th floor is being added. This expansion allows the Liberty campus to expand from 12 inpatient beds to 42 inpatient beds.

4) To better accommodate our growth of inpatients, outpatients, and staff, a full sized kitchen and dining area is being built on the southwest corner of the existing building.

During the construction, there are many ‘smaller’ projects. Clinic space is being closed one area at a time to complete duct work and other necessary construction. Part of Lab is morphing into a blood bank. With minimal interruption, the business of taking care of our patients is continuing. The TC 2 registration area is being temporarily relocated for about 8 weeks. The four registration areas on the 3rd floor will be permanently consolidated into one centralized registration area. We are all getting used to the re-routed parking and walkways as construction flourishes. We know that our beautiful, new buildings will be worth all the dirt, noise, and confusion in the end.

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Approximately 50% of the population receive their healthcare benefits from their employer. With the Affordable Care Act, the role of employers and health care benefits are rapidly changing; therefore, we need to have better information about the source of our health care revenue. It is more than just knowing who is paying our claims (i.e. Anthem, Humana). We have to also understand the source of these dollars coming from the employers. In order for the Payor Relations department to have the ability to negotiate effectively, they must be able to properly identify the number of instances in which patients, with a specific insurance plan, utilize health insurance benefits at CCHMC. During FY14, Registration Services was approached by Payor Relations regarding inaccurate and incomplete Subscriber Employer information being entered in Epic. Upon review of our


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department data, we discovered an average success rate of 37% for all Registration Services locations during the period of 11/3/13 through 12/28/13. This became the perfect I2S2 (Intermediate Improvement Science Series) project! At the conclusion of the improvement project, we were able to increase our average success rate from 37% to 84%. Next Steps Spread this improvement project across all CCHMC registration areas during FY15.

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MASTER CO-PAY REPORT by: Patrick Burke The Master Co-Pay report is a tool that enables CCHMC management to track co-payments due and collected at the time of service, and the reasons why co-payments are not collected. Monthly co-pay collection percentages ranged from 60% to 70% during FY14. The national benchmark is 65%-75%. For additional information about the Master Co-Pay Report, please contact The Registration Services Help-Line at 6-9090 or via email at [email protected].

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8TH ANNUAL REGISTRATION EDUCATIONAL BLITZ by: Joe Geers The 2014 Blitz symposium took place in the Fifth-Third Auditorium at CCHMC. The games this year included: Deal or No Deal, Wheel of JC, Amazing Race, Think-O, Registration Squares, Press Your Luck, and In Your Face. Each game had a theme/topic, which includes, but is not limited to: Legal topics, EPIC, the Joint Commission, Insurance, CARES Standards, Code of Conduct, Outpatient Neighborhood Locations, and the Interactive FaceSheet. Each game also had different prize levels, which were rewarded in tickets, to be redeemed for various CCHMC Logo prizes. Members of the Registration Services Team developed and created the games, questions, and prize rankings.

The Registration Educational Blitz began 8 years ago as a fun and interactive way to educate registrars at CCHMC. It is an entertaining way to remind, refresh, and review registration processes, procedures and hospital policies in a carnival-like setting. We look forward to seeing even more registrars participating in the 2015 Blitz.

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Below is the calendar for the Registration Forums that will take place during 2015. The Forums typically take place in the Old Research Auditorium, between 4:45pm—5:45pm. An Agenda is sent out prior to the Forum confirming the location. Jan 27, 2015 Jul 28, 2015 Mar 31, 2015 Sep 29, 2015 May 26, 2015 Nov 24, 2015

2014 YEAR IN REVIEW CONTRIBUTORS: • Michelle Gray—Director-Registration Services

• Patti Stepp— Director-Operations

• Allene Ford—Access Manager

• Pam Dunaway—Access Manager

• Vicky Robinette—Access Manager

• Pat Burke—Training and QC Auditor

• Kelly Hendrix—Administrative Assistant

• Joe Geers—Project Specialist

• Teresa Marcus—ASR II


We welcome your feedback regard-ing our “Year in Review.”

Please let us know what we can do to make this more useful for you.

Forward your comments to: [email protected]

or 513-636-3199.


• Sign-up 40,000 patients on MyChart • Activate 12,000 patients on MyChart • Collaborate with the Patient Experience team to

design and implement Service Excellence training for all registrars

• Collaborate with Interpreter Services and IS to identify the top 5 languages and have them translated and uploaded into Epic so an electronic signature may be captured for selected registration documents