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University Hospitals Case Medical Center
Cleveland, Ohio
Over 100 certified CHAMs and CHAAs

Responses from Maria H. Kamenos, Vice President, Patient Access Services, University Hospitals Health System

What drew you to the NAHAM credential program?
As someone managing a very large Patient Access department in an integrated health system, the NAHAM credential ensures a level of expertise with revenue cycle concepts, which translate to better quality in the work that we do. It is also a way to provide critical staff development for our teams, and to support the career pathways that we have established which allow for promotional opportunities based on performance and expertise on the job. The ongoing CEU requirement to maintain CHAA and CHAM ensures that certification holders will continue to learn and stay up to date on industry changes throughout their careers.

What aspect of working with NAHAM have you enjoyed the most?
As it relates to certification, the NAHAM website for CHAM/CHAA is very easy to use and works well. The study guides seem to give the staff enough information to prepare for the test, but the test itself is not just a carbon copy of the study guide. It requires the staff person to really know the job. In general, the information shared on the NAHAM website and through the Access Management Journal is always useful.

What are the benefits to your employees?
We worked with our Human Resources department to include CHAA and CHAM in our internal certification recognition program, so that recipients of CHAA/CHAM receive a monetary bonus and potential reimbursement for the costs associated with taking the exam. They also become eligible for promotion to a senior level in the following roles: Patient Access Representative, Scheduling Coordinator and Financial Clearance Representative. It is also required for our Systems Analyst/QA/Trainer positions and any leadership level role in the department. Though earning CHAA/CHAM is no guarantee of a promotion, it does position staff for advancement. It also instills a sense of pride in the team for having earned the credential, which is associated with having a level of expertise about their job. Even when staff are preparing for the exam, we have seen them form cross-departmental study groups which helps promote teamwork and camaraderie across the organization.

Do you see credentialing as being mandatory for hospital patient access workers in the future?
I do see it being more important in the future, as more traditional billing functions move to the front end of the process and now that access to healthcare is a top of mind issue across the country. Patient Access has always been important from a data capture and patient experience perspective, but dramatic changes in the healthcare market have shifted collections up front, and not just co-payments. We now have to understand and explain insurance benefits at a more detailed level, and present payment options for insured patient balances. We must also help patients navigate ACOs, and assist them with understanding and applying for Marketplace insurance plans and Medicaid expansion. Scheduling areas have a critical role to play in the coordination of care for patients, and ensuring that patients have appointments in a timely manner. The data that we capture is shared organization wide through our electronic medical records, and to an expanding network via Health Information Exchanges at the state level. All of these changes impact Patient Access and make it a more complex profession than ever before. Credentialing can ensure that Patient Access professionals have a broad knowledge of these topics and understand exactly how their role has an impact on the patient’s care, experience and the success of the organization.

How is the patient access healthcare profession changing?
The profession is moving traditional business office functions to the front end, so front end staff are armed with the same tools, training and expertise as our billing department staff. In addition, we do it all with the highest degree of customer care, as the patient experience often starts with us. As we continue, I foresee less emphasis on capturing demographic data as patients will be providing that via their health record portals, and more emphasis on real time claims adjudication at the front end. We will be performing Financial Counselor specific functions more broadly, so that the registration and scheduling positions of old will be replaced by hybrid positions that carry a wide range of revenue cycle responsibilities. Scheduling will focus on timely access and coordination of patient care across provider networks, and will likely include a fair amount of “sales” especially as services become commoditized.

What benefits does certification bring to your hospital?
Our health system benefits by having a better-trained, more equipped staff at the front end, which ensures better service to our patients. It also allows employees to learn and grow in their field, and to qualify for promotional opportunities.

Do you believe having credentials will help employees adjust to changes in healthcare?
It will help, especially to the extent which the credential itself keeps pace with market changes. The credential must change to reflect the new realities in the industry, and if it does, will continue to be associated with high quality and expertise.

How do you believe having credentialed professionals will benefit your hospital?
To the extent that the credential keeps pace with the ever-changing market, having credentialed employees will give employers a sense of the level of expertise and knowledge of staff, especially for hires from the outside. For employees, it gives them transferrable skills that can be applied in any patient access environment which is an important component to enable upward mobility in the field. For patients, it ensures that they have a very qualified professional helping them gain access to their healthcare provider and that their experience is much more likely to be a positive one as a result.

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