This document provides a draft model for developing a Patient Access department at Four County Centers. It includes mission and vision statements, a description of services, and proposed key performance measures. Some of the priorities and goals outlined are improving the patient registration flow, ensuring HIPAA compliance, implementing financial counseling, transitioning paper processes to electronic formats, and achieving customer satisfaction, collection, and accuracy standards above 80%. Establishing a call center is also discussed to help schedule clients and free up front desk staff.

1. Patient Access Development Model
These documents is to be utilized as draft documents for Four County
Centers.
1

2. Table of Contents
Page 2. Table of Contents
Page 3. Patient Access Mission Statement
Page 4. Patient Access Vision Statement
Page 5. Description of Service/Department
Page 6.
Page 7.
Page 8.
Page 9.
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3. 3
Patient Access Services Department Mission
Statement
To serve the community by promoting patient support
and meeting the needs of our patients, visitors,
volunteers, and staff.

4. 4
Patient Access Services Department Vision
Patient Access Services strives for
excellence in quality, efficiency, and
customer service.

5. 5
Description of Service/Department
The primary purpose of this Service/Department is to:
• Complete accurate registration in compliance with all regulatory and Four County Counseling Centers
guidelines.
• Verify eligibility and Benefits for mental health insurance coverage, collecting co-insurance,
deductibles and co-pay amounts to improve front end revenue cycle operations.
• Provide financial counseling and payment assistance options for clients who are uninsured or
determined to be ineligible for government programs.
• Provide excellent customer service, adhering to Four County Counseling Center code of conduct and
industry best practices.
• Working in collaboration with clinical staff, insurances, regulatory agencies and support departments.

6. 6
Key Performance Measures and Service Line Best Practices
Registration Accuracy:
Quality of Registration Data
 Demographics (bad addresses)
 DOB
 SSN#
 Valid Phone Number
 ID and Insurance card scanning
 Duplicate records
 Correct Program selected
 Correct Provider selected

7. 7
Key Performance Measures and Service Line Best
Practices Cont’d:
Scheduling Accuracy
Accurate Provider Scheduling
 Appropriate Provider Selected Based on Credentialing
 Timely Notification of Upcoming Appointments
 Special Needs Identified
Front End Revenue Cycle
Front End Billing
 ABN/Medical Necessity
 MSP/Medicare Secondary Payor
 Co-Pays Collected
 Medicaid Presumptive Eligibility Completed

8. 8
Key Performance Measures and Service Line Best
Practices Cont’d:
Billing/POS Collections For Clients Engaged in Key Programs
Identify Specific Program of Engagement For Correct POS Collection
 Identify Recovery Works clients
 Identify Department Child Services Clients
 Vivitrol Clinic Clients
 Determine Percentage of Job Performance
Financial Counseling
Identify Client In Need of Financial Counseling
 Scripting for Financial Counseling
 Financial Data Collection to Identify Clients
 Scheduling Financial Counseling Appointments
 Determine Percentage of Job Performance

9. 9
Key Performance Measures and Service Line Best
Practices Cont’d:
Patient Complaints
Customer Service Complaints
 Timeliness In Client Complaint Resolution
Denials for No Authorizations
Reports No Authorization/Precertification
Report Out Insurance Denials when PAS Responsible for Securing Authorizations
Determine Percentage of Job Performance

10. 10
Key Performance Measures and Service Line Best
Practices Cont’d:
Development of Policies and Procedures
Review and Write Policies and Procedures
Policy Implementation
Employment Engagement/Education
Recognition
 Face Time
 Timely Employee Evaluations
Staff education
Survey Results
 Client Surveys
 Develop Surveys Through Survey Monkey

11. 11
Key Performance Measures and Service Line Best
Practices Cont’d:
“Best Practice” Community Mental Health:
Upfront Collections: Ability to know patient
liability prior to point of service.
Front Desk insurance entry, insurance verification.
Front Office Scanning: Documents imaging and
retrieval technology.
Front Office Signatures: Electronic signature pads
technology.
Eligibility Technology: Ability to batch eligibility of
Medicaid and Major Commercial Insurance.
Wait times – clients waiting to be checked in.
How does our performance currently compare:
Improve POS Collections, identify reports to show cash
collected vs cash to be collected.
Identify EMH system changes to improve data entry and
notifications.
Customer Service training.
Financial Counseling training/implementation
Obtain software for electronic signature.
Utilize batch eligibility systems.
Explore kiosks for check-in.
Establish sign-in for clients.

12. 12
Key Performance Measures and Service Line Best
Practices Cont’d:
Department’s current-state:
• Registration area client flow awkward,
not streamlines.
• No areas for financial counseling that is
HIPAA compliant
• Too much paper, not enough electronic
processes.
 Transfer sheets
 Pre-Auth sheets
 In-take packets
• Re-design registration area.
• Identify area for financial counseling
• Transition paper processes to
electronic processes.

13. 13
Competitive Advantage Now and in the Future:
What processes, skills and services make our
department unique?
• Community Mental Health center in rural
areas.
• Ability to register clients at POS or via pre-
services.
What new/different processes, skills will be needed to
create competitive advantage and success in the next 1
to 2 years?
• To have all registrars credentialed as Certified
Healthcare Access Associates (CHAA), promoting
staff development and staff retention.
• Continue working on streamlining registration
process, promoting feedback to staff, implement
fully operations patient portal.

14. 14
Critical Success Factors/Priorities
Identify the critical success factors and priorities for
Patient Access Services including I.T. requirements
(such as training, software, devices, etc.)
• Improve POS collections
• Improve client registration flow
• Ensure HIPAA compliance
• Implement financial counseling
• Electronic processes
Developing Standard of Work
• Developing process flow
• Developing an education plan and individual
competencies.
• Staff development
• Automated Processes, integration of new
technology and support.
• Managers and Directors (CHAM certified or HFMA
Certification)
• Develop staff scripting for improved POS
collections
• Develop Policies and Procedures
• Conduct annual POS collections training

15. 15
Quality Standards
Goals:
Customer Satisfaction with the registration
process will be consistently> 80% per month.
POS collections >80%.
Account audits > 95% accuracy (<3% error).
Reminder Calls Completed 100%.
Client Financial Screening >98%.
How will goals/standards be measured:
Helpfulness of registration survey.
Daily/monthly cash actual collection.
Monthly audits of client accounts, correct information
obtained and entered.
Automated system.
Implement Financial Counseling.

16. 16
Quality Standards
Pre-Registration Rate >98%
Collection of balances >50%
Insurance Verification >98%
Implement Pre-Services service line.
Set payment plans at POS.
Implement automated systems to batch
verification.

17. 17
Will there be a need for a Call Center:
Call Center:
• Identify call volumes (incoming/outgoing).
• Determine outside calls vs internal calls.
• Staff needed to establish call center.
Benefits of a call center:
• Free up front desk staff
• More efficient scheduling for client and clinicians
• Allow staff to engage clients