EPISODE SUMMARY
Welcome back to The Claim Game! In this episode, Jeremy and Kathryn Zug shift from the "Credentialing" territory of the RCM game board to a new, crucial area: Patient Registration. They explain that while credentialing is about getting your player piece on the board, patient registration is about getting other players—your patients—onto the board so you can actually start playing.
This episode offers a comprehensive overview of the patient registration territory, breaking it down into five key subcategories:
Intake: The process of collecting information. The hosts emphasize that this isn't just "stuffy paperwork" but a critical, dynamic process that sets the stage for a smooth revenue cycle and a great first impression. They share that a poor intake process is directly tied to a high volume of claim rejections and denials.
Provider Assignment & Scheduling: Matching patients to the right provider. This includes considering patient preferences like gender, language needs, and presenting problems to ensure a good match and prevent patient churn.
Checkout: The process isn't complete until the first checkout is done. The hosts explain why this is a critical moment for a practice's reputation and financial health, as it's the best opportunity to collect payments and schedule the next appointment.
HIPAA Compliance: Jeremy outlines the three main HIPAA rules—Privacy, Security, and Breach Notification—and warns that providers should always do more than the bare minimum to hedge against non-compliance, likening it to building a fence 10 feet away from the legal requirement.
Key Performance Indicators (KPIs): The hosts emphasize the importance of tracking KPIs for every territory, including patient registration. They suggest that metrics like provider utilization and patient retention can serve as an early warning system for problems in the patient registration process.
Finally, Jeremy shares a personal story about a triple-booking blunder from his early days, highlighting the importance of having a clear process and humility in place.
KEYWORDS
RCM, Revenue Cycle Management, Credentialing, Patient Registration, Intake, Provider Assignment, Scheduling, Checkout, HIPAA Compliance, KPIs, Claim Denials, Claim Rejections, First Impression, Patient Retention, Patient Care, Revenue
TAKEAWAYS
Patient Registration is Your First Impression: Patient registration is the forward-facing step that sets your practice's reputation. A smooth, clear process directly impacts patient retention and can prevent billing nightmares down the road.
A Clogged Pipeline Leads to Loss: Just like you don't want to wait in credentialing, you don't want to get hung up in patient registration. A well-defined, efficient process helps get patients into the practice and seeing providers as quickly as possible.
Details are a Lifesaver: Collecting correct and complete information at intake—including IDs and insurance cards—is not "stuffy" but a "lifesaver" that prevents a high volume of claim rejections and denials later on.
The First Checkout is a Must: Patient registration isn't complete until after the first checkout. This is your best chance to collect payment and schedule the next appointment, which is "way easier" than trying to do it over the phone later.
Hedge Against HIPAA Breaches: The penalties for HIPAA non-compliance are steep. Instead of doing the bare minimum, build in systems and procedures that keep you "10 feet away" from a potential breach.
CHAPTERS
00:00 Introduction to Credentialing and Its Importance
02:31 Understanding Credentialing KPIs
04:33 Insurance Revenue Target Analysis: Tracking KPIs to Optimize Your Payer Mix
10:59 Time to Contract: Measuring Lead Times for Smarter Credentialing
16:36 Application Completion Accuracy: Pinpointing Errors, Patterns, and Process Gaps
22:11 Credentialing Efficacy: Measuring Success Rates by Payer
25:42 Application Denial Reasons: Uncovering Why Submissions Fail
29:49 Getting Started with Your Credentialing KPI Dashboard
34:12 Case Study: How Credentialing KPIs Turned an Underperformer Into a Key Asset
37:51 Conclusion: Turning Data Into Practice Growth
RESOURCES
Today Sponsors: Blueprint
Learn More About The Claim Game: Visitpracticesol.com/podcast
The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visitingThe Hourglass Learning Hub.
Our Blog: Explore years of educational articles on billing and practice management atPractice Solutions Blog.
Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.
