CHAA Examination Preparation

1
CHAA Examination Preparation

• Future Development Session II
• Pages 113-127
• University of Mississippi Medical Center

2
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.

3
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.

4
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?

5
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.

6
FOCUS - PDCA

• The purpose of FOCUS PDCA is to improve the
  product or service from the CUSTOMERS 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

7
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 were doing the right
  things correctly the very first time.

8
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.

9
Process Reengineering

• This involves FUNDAMENTAL RETHINKING and RADICAL
  REDESIGN of business processes to achieve
  DRAMATIC improvements.
• Changes must be
• Radical
• Dramatic
• Contemporary

10
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

11
Patient AccessTraining Models

• Self-paced Training
• Role Playing
• Experiential
• CBT (Computer Based Training)

• Hands-On Computer Training
• Formal Classroom Training
• Peer-to-peer training

12
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.

13
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

14
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.