Navigating Patient Access during COVID-19

by Aaron Villaverde, Senior Director, Patient Access, and Codi Loughrin, Manager, Patient Access

Patient Access is often referred to within Revenue Cycle as the “front line” or front end operations. By definition, the term front line is used to describe the military members closest to battle. With the ongoing state and federal restrictions limiting public gatherings, school closures, social distancing,  and hospitals experiencing high volume Emergency Department visits, Patient Access is now more than ever a “front line” in the COVID-19 pandemic.

Here are some actions you can take to support your front line Patient Access teams.

Readying/Transitioning Centralized Teams to a Work from Home Model

  • Evaluate the readiness and capabilities for associates to work from home to reduce potential exposure.
  • Leverage local IT and associates to package up office workstations and technical components needed to work from home.
  • Enable high risk team members to continue to work from the solidarity of homes or in remote/offsite areas that allow for social distancing.
  • Block streaming services and other non-essential sites to ensure integrity bandwidth.
  • Enable the ability of VPN access or securely connect and host phone queues from a remote location.
  • Set up necessary tracking processes.
    1. Document the financial and time impact unexpected crises such as COVID-19 have on your daily operations. Documentation helps bring visibility to annual goals in addition to receiving federal or state aid.

Put People First: Ensure Your Team’s Essential Needs Are Met

  • Many associates now face the underlying concern of childcare interruptions and possible lack of household needs, including groceries to sustain their families throughout this time.
  • Identify associates that are high risk as defined by the CDC or whose family circumstances may be disrupted by school or daycare closings.
  • Opt for flexible schedules that allow maximum coverage.
  • Proactively addressing immediate needs will allow teams to focus on their tasks, knowing they are supported.
  • Validate associates homes are safe and supplied, as you transition to a work from home model.
  • Set up a hotline or dedicated email for associates to request support, allowing all associates to have access to dedicated resources.
  • Reconcile mobile phone numbers and personal emails to enable communication for those quarantined or unable to work.

Cross Train and Virtually Equip

  • As volumes of elective procedures change, there will be more flexibility to move those teams to support critical areas, such as Emergency Departments and free-standing triage models.
  • Host virtual training sessions on specific workflow functions. Virtual sessions allow teams to be equipped quickly with the knowledge to conduct the role accurately.
  • Trained associates will be empowered to reach outside their comfort zone to serve the team.
  • Classes should be held virtually, multiple times daily and opened for all facilities. This will ensure the teams are available as staffing needs rise.
  • Set up virtual orientations to onboard new associates.

Empathetic Engagement

  • Increase communications that express the importance of empathy and focusing on Patient Experience.
  • Share tips and reminders of how front line teams can use empathy to calm fears and concerns of patients, along with fellow clinical and Revenue Cycle teams.
  • Give associates the opportunity to take time outs during these stressful and trying times.
  • Provide associates with an internal or external resource they can go to if they want to discuss concerns, fears, or just need the comfort of a calming voice.

Tracking by Dedicated Patient Type

  • Create a patient type or flag that can be applied to the hospital account.
  • Specific codes allow you to track and trend for future revenue recovery and identify how patient volumes were affected.
  • All cancelations should be notated with a COVID-19 flag.
  • Flagged accounts allow procedures to be accurately tracked and rescheduled when elective procedures are brought back to facilities.

Develop a Disaster and Downtime Plan for Registration Processes

  • With the increased demand on hospital servers and internet bandwidth, ensure your team has a downtime registration plan in place.
  • It is vital in high census or triage tent situations to consider implementing a Mass Casualty style quick registration to avoid any delays in clinical care or bottlenecks of isolated patients.
  • If your teams do not have fast track style workflows in place, lean on local clinical leaders for future development of these types of patient workflows.

Continued and Calculated Focus on Claim Submission

  • Remain focused on Claim Edits, Bill Holds and Unbilled, DNFB accounts.
    1. Focus on these accounts to continue to generate cash on hand and ensure claims are submitted timely with a lowered risk of denials.
  • Consider reallocating decentralized associates and other team members who are mandated to work from home and have them focus on the account types previously listed.

Communication Builds Community

  • Senior Leaders should host a daily call with all local facility leaders in attendance.
    1. Keep the pulse on real-time needs and rapid changes, doing so will show you care about your teams and emphasize to your teams their voice matters.
  • Daily calls allow for real-time escalation reducing recovery efforts.
    1. Transparency and Teamwork will breed a culture of faith over fear and will allow you and your teams to succeed during these challenging times
  • Encourage video conferencing calls over voice calls to help keep face-to-face engagement between associates.


Aaron Villaverde is a Patient Access Senior Director with Ensemble Health Partners.  He has served in leadership, operational, and front-line roles throughout patient access.  He has experience in large scale EHR implementations, process improvement, training, and education.  His passion is training and leading multi-disciplined teams across patient access. 

Codi Loughrin is a Patient Access Manager with Ensemble Heath Partners. She has served in Operational roles throughout Patient Access and Front-Line registration. Implementing disaster preparedness and revenue readiness is a true passion. She has experienced firsthand disaster planning, participated in incident commands, and recovery planning throughout multiple facilities – while remaining focused on leading teams with empathy, equipping with knowledge and always remembering the human need in every interaction.