Atlanta, Georgia

Key Drivers: Attract qualified job candidates, Alleviate space issues, Incentive for employees

With three hospitals and 27 neighborhood locations, Children’s Healthcare of Atlanta is one of the nation’s largest pediatric clinical care providers. The health system has had a work-from-home program in place in Patient Access for nearly 10 years. Leaders launched the program to attract qualified job candidates and promote work-life balance among staff, initially offering the option as an incentive to a limited number of employees.

At first, interested and eligible employees were given the option to work from home two days per week. A year later, when gas prices hit an all-time high, leaders increased the work-from-home option to three days per week as a benefit to employees. The system now has 40-plus Patient Access insurance verification employees working this schedule.

To be eligible to work remotely, CHOA employees must have worked for the health system for a minimum of six months and be in good standing with attendance and performance. An internal security guide and confidentiality forms are required for all at-home employees. Agents must also meet daily productivity goals and maintain a quality standard of 95 percent or above. If found in non-compliance with any of these measures, work-from-home privileges may be revoked for a period of up to six months.

CHOA encourages employees to work from home in the same fashion as they do on site. Agents must remain in “ready” mode throughout the day and are provided with the same tools they use on site to document phone calls, faxes and online activity.  Agents use applications to record phone calls with payers, physicians and patients and to capture images from payer web sites. The reference numbers for the recordings and images are tied to patient accounts and centrally stored for enterprise access.

To maintain a paperless office environment, agents securely pass documents back and forth and send/receive faxes electronically. They can also review clinical documentation from the EHR or other systems and document online activities such as checking patient benefits on payer web sites.

Documenting these activities gives management oversight into both the productivity and quality of work performed by at-home agents. According to Tammy Jones, Patient Access & Utilization Review Director, “Anything my team does should result in logging one of the following records in our system – a voice recording, an electronic fax or a captured image from a web site, email, etc.” A significant gap in this activity could indicate an issue with an agent’s productivity. Managers monitor activity through the day, and any gap of 30 minutes or more is addressed with the employee.

For quality assurance, supervisors conduct audits on 40 accounts per month for each employee, including a variety of payers to ensure all account types are covered. Depending on the activity being performed, the review process can include up to 20 criteria ranging from information being loaded in the correct fields to validating authorizations. Supervisors use the technology platform to perform the audit and then reference the hospital’s EHR to ensure that information has been accurately documented into the registration system. A miss on any of these criteria constitutes an error and reduces the employee’s quality percentage, which must remain at 95 percent or above.

CHOA has experienced positive results from its work-from-home program. Employee satisfaction has improved due to increased flexibility, cost savings and less time and money spent on a daily commute. Leaders have also noted that staff are able to work more accounts during a shift at home than one worked in the office as a result of fewer distractions.

The program has also provided savings for the health system such as supply reduction and has addressed space capacity issues. CHOA continues to expand, with plans to build a new $1 billion pediatric center over the next several years. With the work-from-home option, Patient Access is able to meet the increased demand without requiring additional space. It has also freed up additional office space for PRNs who are sometimes needed to cover extra shifts.