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When Stella Coronel books a patient appointment in Thoracic Surgery, she knows she has the support of Doreen Howard at the Patient Service Center (PSC) in Medford. Howard is one of 64 PSC representatives who support ambulatory clinics by verifying registration data and processing managed care referrals before the patient arrives, as part of BWH’s Ambulatory Improvement Initiative (AIM).
A joint BWH/BWPO ambulatory initiative, AIM focuses on customer satisfaction, central pre-processing, training and revenue enhancement. The initiative includes a training and certification program and tools and performance expectations for practice staff and PSC representatives. Before patients arrive for care, practice staff and PSC representatives improve the patient experience by following a set of standard processes to resolve registration discrepancies, obtain referrals and facilitate an accurate insurance claim. “Our vision is for one-stop shopping to make it easier for the patient and practice staff, which allows our clinicians to focus on the medicine,” said Carrie Carlson, operations manager of the Patient Service Center.
This effort puts PSC representatives and ambulatory support staff on the same page, and that makes a difference, according to Joe Albuquerque, who was the administrative director of Thoracic Surgery when AIM was implemented there. “The relationship between our practice and the Patient Service Center is outstanding,” said Albuquerque, who in December moved to Cardiac Surgery where he hopes to implement AIM soon.
According to Lise Bliss, administrator of the Patient Service Center, “One of our goals is to streamline the registration and managed care processes to resolve issues before the patient arrives, which results in a positive experience for both the patient and the practice staff.” The Patient Service Center representatives review scheduled appointments to verify insurance information using online tools, calling payers directly, and, if necessary, contacting patients before their appointments. The PSC then notifies the practice if there are any unresolved issues before patients arrive and check in. Practice staff utilize the PSC express phone or face sheets to resolve any outstanding registration discrepancies.
Using a standardized, predictable process improves customer service, said Albuquerque. “This allows us to deal with more care-related issues and really improves the patient experience,” he said.
Approximately 60 percent of ambulatory practice sites are now employing AIM. The goal of the Ambulatory Improvement workgroup is to implement the PSC process in all eligible ambulatory care sites.
For questions regarding the Ambulatory Improvement Initiative, contact Mary D. Chapin, MS, RN, at email@example.com or 617-954-9513.