Project Status - Cerner



Registration Concepts

A Domain and Solution Overview

Participant Guide

Cerner Millennium Enterprise Registration Management

To obtain permissions to modify, copy or reproduce this document contact:

CernerLearningServices@

or call

(888) 334-1024, then choose option 3.

Table of Contents

1. Introduction 5

Overview and Objectives 5

Length 5

What to Expect 5

Evaluation 5

Project Code 5

Task Summary 6

Domain Overview 6

Solution Overview 6

Workflow Activity 6

Online Assessment 6

2. Domain Overview 7

Facing the Facts: 7

Financial Problems are plaguing health care organizations 7

Revenue Cycle 8

Overview 8

How Does It Work? 8

3. A look into Patient Registration 9

What is Patient Registration or ADT? 9

Registration Information 10

Demographic Information 10

Payer Information 10

Patient and/or Encounter Type 14

About the Registration Department 17

Registration Models - Centralized vs Decentralized 17

Key Registration Processes 18

Pre-Register Patient 19

Register Patient 23

Transfer Patient 24

Update Patient Information 24

Patient Discharge 24

Report 24

Patient Privacy 25

Patient Opt Out 25

4. ERM Solution Overview 27

Introduction to ERM 27

ERM WBT Completion Instructions 27

How Long Will it Take? 27

Is There an Additional Charge? 27

How Do I Get Started? 27

Introduction to ERM Design Considerations 28

5. Work Flow Activity 29

Pre-Registration Workflow Scramble 29

Registration Workflow 29

Registration Workflow 30

Transfer Workflow 31

Discharge Workflow 32

6. Online Assessment 33

Complete the Registration Concepts Assessment via your Learning Plan in MyMedEd. 33

Introduction

Overview and Objectives

Registration Concepts is a self-study, introductory course that focuses on basic workflow and terminology within a typical clinical registration department. As part of this event, you will be briefly introduced to Cerner Millennium Enterprise Registration Management.

Participants will:

1. Become familiar with Clinically Driven Revenue Cycle (CDRC) concept

2. Develop basic understanding of Registration Department terms and processes

3. Correlate basic Registration Department knowledge to ERM (Tools and Application)

Length

Depending on your previous knowledge of the content, plan to spend between 5 to 12 hours completing this self-study.

What to Expect

In this self directed learning event you will be expected to think through concepts and complete tasks which may be new to you. Using your resources, you will be successful.

Evaluation

Participants will complete the online readiness assessment.

Project Code

The project code to use for your time spent on this self study learning event is 172998/5847.

Task Summary

Domain Overview

Read the Domain Overview included within this packet

Solution Overview

1. Read the ERM Introduction in the CMSG

4. From the Cerner Millennium Support Guide page, select ERM – Enterprise Registration Management, from the Overview category, select the Introduction [M2003].

2. Complete the Enterprise Registration Management WBT including the assessment

3. Read the suggested sections in the ERM Design Considerations in the CMSG

5. From the Cerner Millennium Support Guide page, select ERM – Enterprise Registration Management, from the Design category, select Design Considerations [M2003].

Workflow Activity

1. Complete the Workflow Activity included within this packet.

Online Assessment

1. Complete the assessment from your learning plan within MyMedEd.

Domain Overview

Facing the Facts:

Financial Problems are plaguing health care organizations

6. Over 70% of bills require manual intervention

7. LOST: $155,000 per year

8. 70% of business office functions driven by errors in other departments

9. γLOST: $1.12 million per year

10. 21% of claims rejected by payer on first submission

11. LOST: $224,000 per year

12. 20% of those rejected claims never resubmitted

13. LOST: $5 million per year

14. 40% of collectors’ time spent tracking paper trail

15. LOST: $911,000 per year

Revenue Cycle

Overview

Revenue Cycle refers to the sequence of events that facilitate income generation for the healthcare organization.

Scheduling/Admitting/Registration, Health Information Management, Clinical departments and Patient Accounts are vital parts of the revenue cycle and work in concert for the fiscal well being of the institution.

How Does It Work?

Scheduling typically starts the patient care process by coordinating and booking all procedures /orders written by the patient’s physician. In a perfect scenario, basic demographic information, as well as insurance information, is also captured here. This allows facilities to verify insurance coverage and benefits prior to treatment.

When the patient arrives for treatment, Admitting/Registration is responsible for obtaining and/or verifying information necessary for hospital, ancillary and clinic patients. This includes patient and guarantor demographics, financial information and medical information.

Clinical departments are responsible for placing orders and / or applying charges on the encounter and documenting the patient care. Examples of clinical departments include: Lab, Radiology, Surgery, Physical, Speech and Occupational Therapy.

Health Information Management (HIM) provides the diagnosis and procedural codes and information and ensures the accuracy of supporting documentation and other data elements appearing on the bill or claim form, such as the patient’s discharge/transfer status.

Finally, Patient Accounts is responsible for applying/validating charges and billing the appropriate payers for services rendered and collecting outstanding receivables.

Because the vast majority of receivables are paid by third-party insurance, accuracy and timeliness in submitting a claim is critical to the hospital’s fiscal performance. It is essential that all departments work in concert, sharing information, etc. in order to achieve this goal.

A look into Patient Registration

Remember your last visit to the doctor’s office? Or maybe your most recent healthcare encounter was with the hospital. In either case, you most likely were involved with the patient registration process. You know the drill, you arrive at the facility to spend the next 10 to 20 minutes filling out forms and answering questions related to your demographic and insurance information.

What is Patient Registration or ADT?

Patient registration refers to the collection and ongoing maintenance of the crucial, non-clinical information related to each admission, discharge and transfer of a patient within a healthcare organization. Within an automated registration or ADT (Admission, Discharge, Transfer) system, this person level information is housed within the Master Patient Index (MPI).

At its most basic level, the Master Patient Index (MPI) is a database listing of all persons known to have been a patient at a given facility. The MPI should include all patients for which the HIM/Medical Records department has a legal responsibility for maintaining a medical record.

It is very important to understand that the data captured/validated during the registration process begins the processing of a patient’s financial information. What does this mean exactly? In a nutshell, it means that the insurance and demographic information collected here is used to bill the patient and/or his or her insurance carrier for services provided.

Inaccurate or incomplete information may result in inadequate or untimely reimbursement which, overtime and across multiple patients, will negatively impact the organization’s bottom line. As a preventative measure, organizational policy/procedure typically mandates that the patient demographic and insurance information be reviewed with the person each time they present, even if they were just in the facility earlier the same day. In addition, each employee is held accountable for the accuracy of information related to the registrations that they complete.

Registration Information

As discussed above, patient registration refers to the collection and ongoing maintenance of the crucial, non-clinical information related to each admission, discharge and transfer of a patient within a healthcare organization. But exactly what type of information are we talking about? The following are some data elements that are typically captured.

Demographic Information

Personal Identifiers

This will include such things as Name, Birth date and Social Security Number.

Next of Kin and Emergency Contact

Emergency contact can be any individual that the patient specifies, however there are typically very specific rules about who should be listed as Next of Kin. Next of Kin for a child, for example, should be the mother of she is living with the child. If at all possible, the individual listed as Next of Kin should not be the same individual listed as Emergency Contact.

Payer Information

Guarantor

This is the individual who will be financially responsible for the encounter. It may or may not be the same as the patient. Personal identifiers such as name, birth date and social security number are collected on the guarantor.

Financial Class

This is a classification indicating the patient’s method of payment. It is mainly used for reporting purposes. For example, the organization may want to understand the percentage of their patient population which is self pay vs the percentage that has commercial insurance or Medicare.

The following Financial Classes are common:

16. Self Pay (used when the patient is not insured and will be paying out of pocket)

17. Commercial

18. TriCare

19. Medicare

20. Medicaid

21. Workers Compensation (used when the fee for service will be covered under workers comp)

Insurance Subscriber

This is the person who carries insurance on the patient. It may or may not be the same as the patient. It may or may not be the same as the guarantor.

Insurance Plan Information

When collecting insurance information, the registrar must indicate the hierarchy of the plans in terms of responsibility for payment. This ranking/ordering of insurance coverage is referred to as Coordination of Benefits and requires knowledge of the rules of coverage. For example, a particular patient may be covered under Medicare as well as a Blue Care. The registrar will need to list each plan appropriately as either primary or secondary.

The main categories of insurance coverage are as follows:

Commercial

Commercial insurance provides health care benefits to beneficiaries. There are two basic types of commercial insurance coverage:

Group Health Care Plans – Employers normally provide coverage through group health plans administered by commercial payers

Individual or Direct Pay Health Care Plans – Plans purchased by beneficiaries may only pay a fixed amount per day for inpatient visits and may pay directly to the beneficiary instead of the provider

Commercial plans can be primary, secondary or tertiary. If the patient is eligible for Medicare and is of working age with coverage through an employer, the commercial plan is primary.

Medicare supplements are commercial plans purchased by Medicare beneficiaries to cover cost of deductibles and co-pays not covered by Medicare. Medicare supplements are never primary.

TriCare

TRICARE (formerly Champus) is a regionally managed health care program for active duty members and families, retirees and their families, some former spouses, and survivors of deceased military members. The uniformed services include the Army, Navy, Air Force, Marine Corps, Coast Guard, Public Health Service, and the National Oceanic and Atmospheric Administration.

All active duty uniformed service members are enrolled in TRICARE Prime and have no premiums. The United States is divided into ten or more regions. Each region has a different address for submitting claims.

The following types of coverage are primary to TRICARE and must pay first:

• Commercial health plans, including HMO & PPO plans

22. Worker’s Compensation

23. Personal injury protection under patient’s own automobile policy

24. Coverage under the no-fault or uninsured motorists provisions of the patient’s own auto policy

25. Student insurance

Medicaid is not considered a double coverage plan, so TRICARE is always primary over Medicaid.

Workers’ Compensation

Workers’ Compensation is a state-regulated program providing employees and employers with a fair and objective review of claims related to work related incidents. Workers’ Compensation programs are funded by employers and processed by the commercial insurance carrier chosen by the employer.

Employers are responsible for notifying the state of all work-related injuries. It is general practice when a patient is identified as an “injured worker” the liability of paying medical bills is the responsibility of the employer. Prior to admission, documentation should be requested from the employer verifying that services will be covered by Workers’ Compensation.

Medicare

Medicare was created by Title XVIII of the Social Security Amendment of 1965 and is administered by the Centers for Medicare and Medicaid (CMS) [formerly Health Care Financing Administration (HCFA)]. Medicare benefits are available for the following:

26. Individuals 65 years and older

27. Certain disabled individuals

28. Individuals with a diagnosis of end-stage renal disease

Medicare Part A covers inpatient visits, while Part B covers outpatient services as well as physician fees. Insurance companies contract with CMS to process Medicare claims. Medicare Intermediaries for Part A and B are different for each state.

Medicaid

Medicaid is a federal/state program, established by Title XIX of the Social Security Act, which matches federal dollars to the states to provide health insurance for categories of the poor and medically indigent.

Medicaid programs vary from state to state and operate within federal guidelines. Hospitals must obtain provider numbers and follow all state regulations for submitting out-of-state Medicaid claims.

Medicaid is always the payer of last resort. If the patient’s Medicaid card indicates other coverage, that plan must be billed as primary.

Patient and/or Encounter Type

Hospitals categorize each patient and/or encounter based upon the care needed during the visit. Organizations may choose to classify at the patient level, the encounter level or both.

Depending on the processes of the facility, the encounter is added to the patient record during either the scheduling or the registration process. A unique financial number is automatically assigned by the system to each encounter. An encounter classification (type) is manually assigned by the scheduler or registrar at the time the encounter is added, but may change throughout the patient stay as a result of treatment or other circumstances. The patient/encounter type typically will help determine how services are charged/billed. Different classifications may require different types and degrees of supporting documentation. Since registration staff are responsible for assigning/validating the initial patient and or encounter type as well as for maintaining it, it is very important that they be familiar with the rules of patient/encounter classification, i.e. when to use what.

There are two main classes of patient/encounter types. Within each of these classes are various subtypes.

Inpatient

An inpatient meets criteria, whether emergent, urgent or elective, for admission to an acute care facility, as determined by his or her physician. An inpatient occupies a bed and receives services such as room and care, diagnostic and therapeutic services and medical and/or surgical services. An inpatient may be further defined and Skilled Nursing is one example of this.

29. Skilled Nursing: patient requires a qualifying three-day stay in an acute care facility within 30 days. A patient must be discharged from an Inpatient status prior to being admitted to a Skilled Nursing bed in the same facility.

Outpatient

An outpatient is classified as not meeting inpatient criteria and receives services other than room and care. An outpatient is further defined in one of the following classifications:

30. Observation: patient requires the use of a bed and periodic monitoring by nursing or other staff. Observation services usually do not exceed one day. Services exceeding 48 hours of observation charges will be denied by the majority of payers, specifically Medicare.

31. Outpatient Surgery: patient requires a surgical procedure and the use of a bed and periodic monitoring by nursing or other staff.

32. Routine: requiring no special care

33. Diagnostic: patient requires diagnostic treatment or services but not the use of a bed and/or monitoring.

34. Emergency: patient requires services in an Emergency Department for a life-threatening or emergent situation.

35. Urgent: Patients that must be admitted within 48 hours due to health reasons are the next step towards less severity.

36. Elective: In this category the patients are not in immediate danger and registration can be postponed.

37. Reoccurring or Series: a patient may have reoccurring encounters as a result of a long treatment process. A patient on kidney dialysis would be representative of this. Remember that each encounter is identified by a unique financial number which is used to bill for services. Recurring encounters all share the same financial number and will be billed together on the same insurance claim or patient statement.

The five most common hospital patient/encounter types are:

38. Emergency

39. Inpatient

40. Outpatient

41. Observation

42. Reoccurring or Series

Following are examples of possible transfer scenarios:

43. Emergency > Observation

44. Emergency > Observation > Inpatient

45. Observation > Inpatient

46. Outpatient Surgery > Observation

47. Outpatient Surgery > Observation > Inpatient

48. Outpatient Diagnostic > Observation

49. Outpatient Diagnostic > Observation > Inpatient

[pic]

Observation, Diagnostic Outpatient and / or Emergency encounter types may be transferred to an Inpatient status by written order of a physician. However, Inpatients may not be transferred back to any Outpatient encounter type.

About the Registration Department

The Registration department can be independent but is often times integrated with scheduling. In either case, it often becomes the central connector between patients, physicians, and other hospital staff and acts as the gatekeeper of ‘resources’ like surgical suites, rooms and beds, staff physicians, nurses, and laboratory facilities.

Since the registration process is typically the first contact that patients and their families have with the facility, the department plays a public relations role that transmits as the face of the organization.

Some Registration departments, following their public relations image, make available to patients and families information booklets on the “do’s” and “don’ts” of hospital stays. This information reduces the “unknowns” and eases some of the stress. The Patient’s Bill of Rights is a commonly found document explaining the hospitals obligations to patients.

The Registration department often encompasses a central bed board function that ‘owns’ the rooms and beds in the facility and controls their assignment. Depending on the organization’s bed allocation policy, beds may be assigned to patients by buildings, by floors, or by patient care classifications. Bed boards or visual display boards have traditionally been used to control and monitor the allocation of beds. However these days, many organizations are replacing these manual visual display boards with computerized displays which are being integrated with hospital information systems.

Registration Models - Centralized vs Decentralized

There are two common patient registration models used in hospitals. The centralized registration department model is structured so that all registration (be it inpatient or outpatient, cardiology or radiology, etc) takes place through the physical location of one centrally located registration desk. The second is the decentralized or ‘departmental’ registration model; this means that every clinic and department has its own registration staff.

Some organizations may use a modified version of the centralized registration. In this type of model, a centralized registration department exists, however, in addition, there are registration clerks scattered throughout the different departments.

Key Registration Processes

There are essentially five main processes related to Registration. Most of these processes occur in each hospital, although the specific work steps for each may vary between departments and some departments may not perform all five.

[pic]

Pre-Register Patient

In the perfect scenario, portions of the required registration information are collected/verified before the patient presents for his or her encounter. This is possible however only in those instances when the visit or encounter has been scheduled in advance. In this case, information will be collected/validated at the time the appointment is scheduled and in addition, during a ‘pre-registration’ process. Many healthcare organizations will typically try to pre-register as many patients as possible.

Pre-registration is obviously not an option for patients who come in unexpectedly through the emergency department. Rather, in these cases, it is quite common for the emergency department personnel to complete a quick ‘short form’ registration prior to treating the patient. This short form registration must be later updated/completed by registration or ER personnel.

For patients who are scheduled in advance however, pre-Registration may be completed in a variety of ways: in person, via telephone conversation, by fax, by mail, etc. Additionally, with the increasing popularity and use of the Internet, many hospitals offer pre-registration through their websites via electronic forms that collect demographic information along with health insurance particulars.

Through pre-registration, hospitals are able to more efficiently allocate resources and gather important patient information prior to the patient’s arrival. Individuals that pre-register with the fore knowledge that they will be Inpatients may have a room and bed pending upon registration. Pending indicates that resources, in this case a bed and room, have been allocated in advance, or ‘held’, for a particular patient. Additionally, the pre-registration process reduces the patient wait time on the day of the appointment.

Perhaps most importantly though, pre-registration begins the upstream processing of a patient’s financial information. At pre-registration, the registrar can identify and validate the patients intended method of payment. The first step is to determine whether or not the patient has insurance. If they do not, credit counseling may be necessary. If they do, insurance verification is completed by the registrar. Additionally, depending on the reason for visit, insurance companies may require patients and/or providers to obtain pre-authorization, pre-certification and/or referrals. This is typically handled by the scheduler at the time the appointment is scheduled, however if it is not, it can be completed during pre-registration.

Insurance Verification

This is the process of checking with the insurance company to ensure that the patient does in fact have the insurance coverage that they say they do. This may be a manual or automated process.

Pre-authorization / Pre-certification

Pre-authorization or pre-certification (these two terms mean essentially the same thing) is an assessment, prior to elective inpatient hospital care or specific outpatient procedures, to determine whether proposed health care services meet medical necessity criteria for payment under a health benefits plan. In other words, it is a step the healthcare organization should take to validate that the needed procedure is covered under their plan.

The healthcare facility is responsible for initiating contact during a very specific time frame either before certain services are rendered (such as scheduled admissions, elective surgeries, or procedures such as MRI) or within a specific time frame after emergency care is provided and reimbursement may be negatively impacted if it is not done. Many insurance companies require phone calls, some require faxes. Some say you can view the information on their website; others say that is not good enough. Some allow you to leave a message; others say you have to speak to a person. All communication of this sort must be thoroughly documented in case a claim is questioned. Complete documentation could persuade an insurance company to pay even if they have initially denied a claim.

Referrals

A referral is an authorization from a Primary Care Physician to receive care from a specialist or other treatment such as hospital admissions, lab or x-ray services or outpatient procedures. The referral authorizes a specific number of specialist visits during a specified period of time.

Advancements in automation have made it possible for healthcare organizations to complete this insurance verification online by linking directly to insurance databases. In many organizations however, this continues to be a manual procedure. In this case, registrars will typically contact the insurance institution by phone or fax to confirm the particulars of the insurance coverage.

Benefits to a facility may be reduced or claims denied if proper authorization is not obtained prior to services being rendered. An example of reduction of benefits is failure to notify the insurance company of an admission for an emergency or inpatient service within 24 – 48 hours.

Advanced Beneficiary Notice (ABN)

In addition to the normal pre-certification and/or referral process, further processing is required for patients with Medicare. Medicare regulations require that the provider notify the patient and provide proof of this notification, if a treatment is determined NOT to be medically necessary, and therefore, not covered or covered under reduced benefits. Currently, the “Advanced beneficiary Notice” (ABN), developed by Medicare, is the most common liability waiver to be encountered. The ABN, previously called the “Waiver of Liability,” is an agreement signed by the beneficiary or the beneficiary’s representative, giving the provider permission to proceed with the service and bill the patient or other insurance. When a Medicare beneficiary is not informed certain services or items may not be covered, he or she is not liable, and the provider of service is mandated to assume the costs.

The notification letter can be manually or computer generated and must contain the following:

50. An exact description of which services/items are considered non-covered

51. An explanation of why service/items are not covered

52. A statement from the beneficiary or his/her representative agreeing with the notice

53. The signature of the beneficiary or his/her representative and date of signature

54. The signature of provider witness and date of signature

Medicare Secondary Payer

The Medicare Secondary Payer (MSP) Questionnaire must be completed for all Medicare beneficiaries for each inpatient or outpatient visit in order to determine whether Medicare coverage will be primary, secondary or tertiary.

Verifying MSP information means confirming that the information previously furnished about the presence or absence of another payer that may be primary to Medicare is correct, clear, and complete and that no changes have occurred.

Medicare is secondary under the following circumstances:

55. Medicare beneficiaries age 65 or older with Employee Group Health Plan (EGHP) coverage based upon their own current employment status or spouse’s employment status with an employer that has 20 or more employees

56. Beneficiaries eligible for or entitled to Medicare on the basis of End Stage Renal Disease (ESRD) and within the 30 month coordination period

57. Medicare beneficiaries under age 65 who are entitled to Medicare on the basis of disability and are covered by a Large Group Health Plan (LGHP) based upon their own current employment status or spouse’s employment status with an employer that has 100 or more employees

58. Claims involving automobile or non-automobile liability or no-fault insurance

59. Claims involving government programs (Worker’s Compensation, Department of Veteran’s Affairs, or Black Lung benefits)

Register Patient

 

Typically a patient will present for registration on the day/time of scheduled care in order to complete his/her registration. If pre-registration has been completed for this encounter, the registration process may take only a few minutes.

As part of the registration process, consent forms are signed and patient information is validated (even in the case where pre-registration was completed). Inpatients are assigned a room and bed. In some cases, such as for an insurance co-pay, cash is collected.

Consent Forms

The registration department is generally responsible for acquiring patient’s signatures on consent forms upon registration; consent forms are not filled out during the pre-registration process. Consent forms can be separated into two classifications:

60. General treatment and procedures consent forms

61. Special consent for medical or surgical procedures

Normally the registration department is accountable for the general consent forms, where as the special consent forms, needing informed consent, is the responsibility of the physicians and other clinical members of the medical team.

Routine procedures like x-rays, laboratory work, and simple medical treatment are typically covered in the general consent form. Anesthesia, major or minor surgery, radiation therapy, experimental procedures, and x-ray treatments are covered in the special consent forms.

It is important to note that registration can take place outside of the physical location of the registration desk; however it still remains a function of the registration department. Emergency care in the ED is a good example of this. Once the patient is coherent and in a condition to provide information, the ED admission clerk can visit the patient bedside and obtain all required information.

At many healthcare facilities, when patients present for admittance to the hospital, they undergo Pre-Admission Testing (PAT). These are typically lab tests from which the results, along with the medical history provided by the provider, can be analyzed to determine the demand for hospital resources during the patient stay. This is called a length of stay analysis report.

Transfer Patient

Patient transfers are normally tracked and documented by either the registration department or nursing in an effort to maintain and monitor patient flow. For inpatients bed allocation is normally assigned by the care category; allocation policies will depend upon the institution. To direct and supervise the bed assignments, visual display maps or bed boards were traditionally used. Most hospitals are replacing these traditional methods with computerized displays that allow for instantaneous updates.

Update Patient Information

After the patient has been registered, the registration department has the responsibility of maintaining (updating as necessary) the patient demographic and insurance information for the facility. For example, the encounter type may change during the patient’s stay and this would need to be updated.

Patient Discharge

In managing the entire continuum of the patient’s hospital experience, the registration department may handle the discharging of the patient. As a satellite of the registration department, some nursing departments in certain hospitals can discharge patients using the same registration system.

Report

In order for the registration department to manage the patient population in the hospital, the department compiles a daily census report. To manage the hospital beds, the assign beds report is created. These reports are just two examples of the types of reports the Registration department creates and utilizes in order to increase the efficiency of the hospital.

Patient Privacy

One of the more recent HIPAA (Health Insurance Portability and Accountability Act of 1996) mandates with significant registration impact is ‘Patient Privacy’. This government statute stated that on April 14, 2003 all healthcare entities must capture patient privacy acknowledgements and store them on record. Most organizations prefer to do so electronically, but for many, this remains a manual process. Patient Privacy maintains the patient’s privacy and consent acknowledgements. This is not to be confused with consent for treatment. Privacy is the right of the individual (patient) anonymity and confidence that they will be against unwarranted intrusion. Consent is the documented and signed permission by the patient that their information can be used or disclosed by the provider for purposes of treating the patient, obtaining payment for services rendered to the patient or maintaining the quality of healthcare operations for the provider.

The privacy notice or policy of the healthcare entity that is given to the patient defines how the provider organization uses or discloses the patient’s information in the coarse of providing treatment to the patient, obtaining services rendered to the patient or for maintaining the quality of healthcare operations for the provider. The privacy notice or policy is defined by each healthcare entity and can include only privacy provisions or both privacy and consent provisions.

Patient Opt Out

“Patient Opt Out” is related to Release of Information. This is where the patient may choose to prevent their information from being released to the public. This is in the case where they do not want to receive any visitors, receive flowers, telephone calls, mail, and clergy visits.

ERM Solution Overview

Introduction to ERM

Read the ERM Introduction in the Cerner Millennium Support Guide

62. From the Cerner Millennium Support Guide page, select ERM – Enterprise Registration Management, from the Overview category, select the Introduction [M2003].

ERM WBT Completion Instructions

The WBT will provide hands-on practice with Cerner’s Enterprise Registration Management solution.

How Long Will it Take?

Expect to spend between 2-3 hours completing the WBT.

Is There an Additional Charge?

As part of the enrollment fee for the ERM Design and Build class, each enrolled client or Business Partner may access and complete the WBT twice.

How Do I Get Started?

Clients and Business Partners

63. Access this WBT through your Learning Plan in MyMedEd.

➢ Within MyMedEd, select ‘My Learning Plan’ from the menu on the left side of the screen.

➢ On your Learning Record, within the ‘Scheduled Class Sessions’ section, locate the line item for Enterprise Registration Management Design and Build Basic. Click the ‘Before Class/more info’ link.

➢ There will be several ‘before class’ items displayed. Locate the line item for Enterprise Registration Management. Click the ‘Begin’ link.

NOTE: If clicking the link does not launch the WBT, the problem may be a pop-up blocker. To correct, the preferences for the pop-up blocker must be set to allow pop-ups from *..

Associates

64. Access this WBT through the course catalog page in MyMedEd.

➢ Within MyMedEd, select Course Catalog from the menu on the left side of the screen.

➢ Search for Registration.

➢ Select the Enterprise Registration Management WBT.

Introduction to ERM Design Considerations

Read the suggested sections in the ERM Design Considerations in the CMSG

65. From the Cerner Millennium Support Guide page, select ERM – Enterprise Registration Management, from the Design category, select Design Considerations [M2003].

66. Read the following sections:

67. Conversations

68. Worklists

Work Flow Activity

Pre-Registration Workflow Scramble

Registration Workflow

[pic]

Transfer Workflow

Review this workflow. There is no activity to complete but to think about the functionality that would be used here.

[pic]

Discharge Workflow

Review this workflow. There is no activity to complete but to think about the functionality that would be used here.

[pic]

Online Assessment

Complete the Registration Concepts Assessment via your Learning Plan in MyMedEd.

➢ Within MyMedEd, select My Learning Plan from the menu on the left side of the screen.

➢ On your Learning Record, locate the line item for Registration Concepts. Click the ‘Before Class/more info’ link.

➢ There will be several ‘before class’ items displayed. Locate the line item for Registration Concepts Assessment. Click the ‘Begin’ link.

Revision history for ERM Guide: Instructor Version

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Workstep Fill in the Blank

B. _________________________________________________

K. _________________________________________________

N. _________________________________________________

Review the following Workflow – notice the missing steps (box B, K, N)

Complete the Workstep Fill In the Blank at the bottom of this page

Complete the Cerner Functionality Fill In the Blank at the bottom of this page

1. For each box in the workflow below, write the number of the corresponding game piece.

2. Fill in the blanks where it asks for Cerner End User Functionality. Be specific - which application, which function (worksteps,etc)

No

9. Collect demographic information and assign to room/bed

8. Contact each scheduled patient to initiate pre-registration

7. Does patient have insurance??

1. Collect demographic information

6. Arrange for self-pay or credit counseling

5. Access scheduled patients list

GAME PIECES

3. Should patient be pended to room/bed?

2. Complete insurance verification

4. Able to reach/speak with patient?

Application/Function

Application/Function

Application/Function Functionality Used?

B

No

Yes

B

Yes

No

END

Yes

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Notes

Notes

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Notes

Notes

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Notes

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