It was only four years ago when Teresa Bassett became the patient access director at Riverside Health System (RHS) in Newport News, VA, and immediately recognized a few disturbing trends. Bassett's top objective was to reduce accounts receivable (A/R) by working with her registration staff. However, the staff members weren't yet performing time-of-service (TOS) collections efforts, and when she learned that the business office was touching 85% of every-thing that came out of registration, she knew that there couldn't be a quick fix. "It wasn't just bad. It was way bad," said Bassett, who spoke during the NAHAM Annual Conference in May.

However, the business office now steps in only 24% of the time, and these instances are rarely due to a registration error. "It's nice to know that we're finally not causing patient accounting additional work," Bassett said.

The secrets to success: switching from manual to electronic audits; studying quality reports; conducting frequent, on-the-spot, informal training; launching a dedicated collections initiative, and receiving staff support.