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GEN5668 Mastering Patient Access and Care Coordination

$199.00
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The Executive Diagnostic and Governance Toolkit

Mastering Patient Access and Care Coordination

Score your own function red, amber or green, find out which part is weakest, and walk into the next budget round able to defend what you want to fix. Built for leaders reviewing Patient access and care coordination.

$199 one-time
30-day money-back guarantee Verified against latest insights, updated access provided within 24h

Each order is checked and updated against the latest insights before delivery. That is why access takes up to 24 hours rather than being instant.

What you walk out with
A scored, ranked picture of your own function, and a defensible answer to what to fix first.
1 You stop guessing where you stand.
You finish with a score, not an opinion: every part of your function rated red, amber or green, with the weakest ranked first. Evidence: a Quick Scan for the shape of it, then seven domain assessments of 30 scored questions each, 210 in all, rolled into one scorecard, plus a maturity radar and a current-versus-target gap analysis.
2 You can defend the decision.
You walk into the budget round with the gap named, the owner named and done defined, instead of a case built on instinct. Evidence: project charter, scope statement, RACI, requirements traceability and work breakdown structure, pre-filled in your domain's language.
3 The work actually moves.
The month after the decision is already built, so nothing stalls waiting for someone to design a form. Evidence: more than 60 project templates across all five PMBOK process groups, plus runbooks, SOPs, a KPI framework, audit checklists and a risk matrix. 55 to 65 files in total.
4 You use it the day it lands.
No blank templates to interpret. Every workbook opens with what it is, who uses it, when, how, a 1 to 5 scoring guide, what good looks like, and a worked example you delete and type over.
The Quick Scan is one sitting. You will know your weakest area before the day is out.
Nothing in it is generic project management: the build rejects any file that could belong to another course. Updated after you enrol, so it reflects where the work stands now. The 144-chapter course is included behind it, for the parts you want to go deeper on.
You own the function that connects patients to care—and it’s being pulled in every direction.

The situation this is built for

Patient access and care coordination used to mean scheduling and authorizations. Today, it’s navigating a fractured landscape of specialty networks, payer mandates, digital triage tools, and rising patient expectations. You’re expected to reduce friction while managing clinical appropriateness, regulatory compliance, and provider satisfaction. The workflows you built five years ago are buckling under new demands. Referrals leak out of network. Prior authorizations delay care. Patients fall through the cracks between primary and specialty providers. And now, new models are emerging that claim to automate or outsource the very work you’re accountable for. You need to know: what parts of your operation are still essential, what can be improved, and what might be replaced.

Who this is for

Director of Patient Access in a multi-site health system or integrated delivery network, responsible for end-to-end patient journey from referral to first appointment, including scheduling, insurance verification, prior authorization, care coordination, and handoffs to specialty providers.

Who this is not for

This course is not for frontline staff, technology vendors, or consultants selling tools. It is not about implementing a specific software or adopting a new platform. It is for leaders who own the function and must decide how it evolves.

What you walk away with

  • Map the full lifecycle of patient access workflows across your system
  • Identify hidden coordination failures in specialty referral management
  • Assess the real defensibility of your current care coordination model
  • Align cross-functional stakeholders on shared access performance metrics
  • Build a living implementation playbook tailored to your organization

How this maps to your situation

  • Current-state workflow mapping
  • Failure point identification
  • Stakeholder alignment assessment
  • Future model viability analysis

Before vs. after

Before
Fragmented workflows, inconsistent metrics, and reactive decision-making define patient access operations.
After
A unified, auditable, and strategically aligned access model with clear ownership and measurable outcomes.

What's included with your purchase

  • 12 modules with 12 chapters each (144 chapters)
  • Downloadable templates and worked examples for every module
  • Hand-built implementation playbook delivered alongside course access
  • 30-day money-back guarantee

Delivery and format

  • Course and learning environment access provisioned within 24 hours of purchase
  • Hand-built implementation playbook delivered alongside course access

Format: Text-based modules and chapters in the Art of Service learning environment, plus downloadable templates and worked examples for every chapter, plus the hand-built implementation playbook delivered alongside course access.

Time investment: Approximately 3 hours per module, or 36 hours total, designed to be completed at your pace over 8–12 weeks.

If nothing changes
Without a deliberate assessment, patient access will continue to operate in silos, leading to preventable care delays, rising denial rates, stakeholder misalignment, and increased vulnerability to external disruption. The longer you wait, the more reactive your model becomes—and the harder it is to reclaim control.

How this compares to the alternatives

Most resources focus on technology implementation or staff training. This course is different—it’s for leaders who must assess, defend, and evolve the function itself. No other program breaks down the actual work of patient access with this level of operational specificity.

Also included: the full course, for when you want the reasoning behind a finding (12 modules, 144 chapters)

Depth reference. The diagnostic and the templates stand on their own; this is what to read when you want the reasoning behind a finding.

Module 1. Defining the Scope of Patient Access Today
Establish a clear, current-state definition of patient access in your organization, including boundaries, handoffs, and accountability gaps.
12 chapters in this module
  1. Understanding the end-to-end patient access journey from referral to first visit
  2. Mapping the difference between scheduling and true access coordination
  3. Identifying where patient access overlaps with care management teams
  4. Clarifying ownership of prior authorization initiation and follow-up
  5. Documenting the roles of referral coordinators versus access navigators
  6. Assessing how payer-specific requirements shape access workflows
  7. Defining what counts as a 'closed loop' referral in your system
  8. Tracking where patients drop out between referral and appointment
  9. Measuring the time from referral receipt to first available slot
  10. Analyzing variation in access protocols across service lines
  11. Evaluating how telehealth options are integrated into access paths
  12. Benchmarking your access definition against peer institutions
Module 2. The Anatomy of a Referral Workflow
Break down the components of a referral, from origin to fulfillment, and identify failure points in handoff, tracking, and closure.
12 chapters in this module
  1. Tracing the lifecycle of a referral from primary care to specialty intake
  2. Identifying the data elements required to process a referral
  3. Mapping how referrals are routed across departments and EMRs
  4. Analyzing the role of fax versus digital referral systems
  5. Documenting the intake coordinator’s responsibilities per specialty
  6. Assessing how referral completeness is verified at receipt
  7. Defining the escalation path for incomplete or ambiguous referrals
  8. Tracking the time between referral receipt and patient contact
  9. Measuring the percentage of referrals that never convert to appointments
  10. Evaluating how specialty clinics prioritize incoming referrals
  11. Understanding how clinical triage influences scheduling urgency
  12. Creating a referral disposition log for audit and improvement
Module 3. Insurance Verification and Benefits Workflow
Examine the end-to-end process of verifying coverage, benefits, and patient responsibility, including timing, accuracy, and escalation.
12 chapters in this module
  1. Defining the standard timing for insurance verification in access workflows
  2. Mapping the steps from patient registration to benefits confirmation
  3. Identifying which team owns real-time eligibility checks
  4. Assessing how out-of-network referrals are flagged and managed
  5. Documenting the process for verifying prior authorization requirements
  6. Analyzing how patient financial responsibility is communicated pre-visit
  7. Tracking the accuracy of benefits data at time of scheduling
  8. Measuring the rate of post-verification coverage denials
  9. Evaluating the use of automated versus manual verification tools
  10. Defining escalation paths for unresolved insurance questions
  11. Understanding how Medicaid and Medicare Advantage differ in verification
  12. Creating a benefits verification audit trail for compliance
Module 4. Prior Authorization: Process and Pain Points
Dissect the prior authorization lifecycle, from initiation to approval, and identify delays, ownership gaps, and clinical documentation needs.
12 chapters in this module
  1. Identifying which conditions and services routinely require prior authorization
  2. Mapping the workflow from provider order to PA initiation
  3. Defining who owns PA submission across different service lines
  4. Analyzing the clinical documentation required for each specialty
  5. Tracking the average turnaround time for PA decisions
  6. Measuring the denial rate and common reasons for rejection
  7. Evaluating the role of clinical staff in PA justification
  8. Assessing how PA status is communicated to patients and providers
  9. Documenting the process for urgent versus routine authorizations
  10. Understanding how payers differ in PA requirements and timelines
  11. Creating a PA tracking dashboard for operational visibility
  12. Building a library of successful prior authorization templates
Module 5. Scheduling Across Complex Service Lines
Explore how scheduling differs by specialty and the coordination required to align capacity, clinical needs, and patient preferences.
12 chapters in this module
  1. Understanding the scheduling rules for high-demand specialties
  2. Mapping how appointment templates are designed per service line
  3. Analyzing the role of clinical triage in slot allocation
  4. Defining what constitutes a 'clinically appropriate' first appointment
  5. Measuring the gap between requested and offered appointment dates
  6. Evaluating how patient travel distance influences scheduling decisions
  7. Assessing the use of open access versus routed scheduling models
  8. Tracking no-show and cancellation rates by specialty and location
  9. Understanding how interpreter needs are captured and accommodated
  10. Documenting how same-day referrals are prioritized in the schedule
  11. Measuring the time from referral to scheduled appointment
  12. Benchmarking scheduling efficiency across provider groups
Module 6. Care Coordination Handoffs and Transitions
Examine the formal and informal handoffs between access teams, providers, and care managers, and identify where continuity breaks down.
12 chapters in this module
  1. Mapping the handoff from access coordinator to care manager
  2. Identifying the information included in a care coordination referral
  3. Defining what triggers a warm handoff versus a cold transfer
  4. Analyzing how patient risk stratification influences handoff timing
  5. Documenting the role of care coordinators in pre-visit preparation
  6. Measuring the rate of patient engagement post-handoff
  7. Evaluating how care plans are communicated across teams
  8. Assessing the use of standardized handoff checklists
  9. Understanding how behavioral health referrals differ in handoff process
  10. Tracking the time between appointment scheduling and care manager contact
  11. Defining the feedback loop from providers to access teams
  12. Creating a shared care transition dashboard for visibility
Module 7. Patient Communication and Engagement
Review how patients are informed, reminded, and supported between referral and first visit, and where communication gaps occur.
12 chapters in this module
  1. Mapping the patient communication timeline from referral to visit
  2. Analyzing the channels used for appointment reminders and confirmations
  3. Identifying how language and literacy needs are addressed in outreach
  4. Measuring patient response rates to automated communication
  5. Evaluating the effectiveness of pre-visit education materials
  6. Assessing how transportation needs are identified and addressed
  7. Documenting the process for rescheduling and cancellation follow-up
  8. Understanding how patient preferences are captured and honored
  9. Tracking patient-reported barriers to keeping appointments
  10. Measuring the impact of reminder timing on no-show rates
  11. Defining the role of patient navigators in engagement
  12. Creating a patient communication audit for compliance and clarity
Module 8. Data, Metrics, and Performance Monitoring
Establish the core metrics for access performance and build systems to track, report, and act on them.
12 chapters in this module
  1. Defining the key performance indicators for patient access teams
  2. Measuring the referral-to-appointment cycle time by specialty
  3. Tracking the percentage of referrals that convert to visits
  4. Analyzing no-show and cancellation rates across service lines
  5. Evaluating the accuracy of insurance verification at time of service
  6. Measuring prior authorization approval and denial rates
  7. Assessing patient satisfaction with access coordination
  8. Creating a monthly access performance dashboard
  9. Defining thresholds for operational intervention
  10. Understanding how data latency affects reporting accuracy
  11. Mapping data sources across EMR, billing, and access systems
  12. Building a data governance process for access metrics
Module 9. Cross-Functional Stakeholder Alignment
Identify the key stakeholders in access workflows and establish alignment on goals, expectations, and accountability.
12 chapters in this module
  1. Mapping the stakeholders involved in patient access workflows
  2. Defining the role of medical directors in access policy
  3. Analyzing how provider scheduling preferences impact access
  4. Understanding payer requirements as a stakeholder force
  5. Assessing the influence of revenue cycle leadership on access
  6. Documenting care management’s expectations for handoffs
  7. Evaluating how IT supports or hinders access workflows
  8. Measuring alignment between access teams and service line leaders
  9. Creating a stakeholder communication plan for access changes
  10. Defining shared goals for referral conversion and patient experience
  11. Holding quarterly access alignment meetings with leadership
  12. Building a stakeholder feedback loop for process improvement
Module 10. Regulatory and Compliance Considerations
Review the compliance landscape for patient access, including privacy, equity, and documentation requirements.
12 chapters in this module
  1. Understanding HIPAA requirements in patient access workflows
  2. Mapping how protected health information is shared during referrals
  3. Analyzing compliance with ADA in appointment scheduling
  4. Evaluating language access compliance under Section 1557
  5. Documenting how prior authorization supports medical necessity
  6. Assessing compliance with payer-specific access mandates
  7. Understanding how equity metrics are tracked in access data
  8. Measuring wait times by patient demographic groups
  9. Creating an audit trail for referral and scheduling decisions
  10. Defining policies for handling patient complaints about access
  11. Reviewing documentation requirements for care coordination
  12. Building a compliance checklist for access process changes
Module 11. Technology and Workflow Integration
Assess how current systems support or hinder access workflows, and identify integration points and data gaps.
12 chapters in this module
  1. Mapping how EMR tools are used in access coordination
  2. Analyzing the role of scheduling software in access efficiency
  3. Identifying where manual workarounds exist in digital workflows
  4. Evaluating how referral management systems connect to EMRs
  5. Understanding how data flows between insurance verification tools
  6. Assessing the use of patient portals in access workflows
  7. Measuring the time spent on double data entry across systems
  8. Documenting how clinical notes are accessed during intake
  9. Reviewing the accuracy of automated eligibility checks
  10. Defining requirements for system interoperability in access
  11. Creating a technology gap analysis for your access function
  12. Building a roadmap for workflow-technology alignment
Module 12. Future-Proofing the Access Function
Synthesize insights from the course to assess your function’s trajectory and plan for sustainable evolution.
12 chapters in this module
  1. Assessing which parts of access are defensible long-term
  2. Identifying tasks that could be automated or streamlined
  3. Evaluating the risk of external models replacing internal functions
  4. Defining the core capabilities that must remain in-house
  5. Measuring the adaptability of current workflows to change
  6. Creating a three-year vision for the access function
  7. Building a case for investment in access transformation
  8. Documenting dependencies on external partners and payers
  9. Assessing team skills against future workflow demands
  10. Designing a pilot to test a reimagined access model
  11. Establishing a rhythm for access model reassessment
  12. Writing the first draft of your access evolution playbook

Frequently asked

Who is this course designed for?
This course is for Directors of Patient Access who own end-to-end coordination from referral to first appointment and are responsible for performance, compliance, and stakeholder alignment.
How is the course structured?
12 modules, each containing 12 chapters (144 chapters total).
Does this course cover specific software or vendors?
No. This course focuses on the work itself—workflows, decisions, meetings, and artifacts—not technology platforms or vendor solutions.
What will I have at the end?
A comprehensive understanding of your current access model, a gap analysis, and a tailored implementation playbook to guide next steps.
Is there a certificate of completion?
Yes, upon finishing all modules, you’ll receive a certificate of completion in patient access and care coordination leadership.
What formats do the templates come in?
The implementation playbook downloads as PDF and editable XLSX. The course reads in your learning environment and exports to PDF for offline use. The files are yours to keep.
Can I share this with my team?
The licence is per person. Team pricing opens from three seats: reply to the order confirmation with TEAM and we will set it up.
How quickly can I start?
The diagnostic is one sitting and the templates work straight out of the kit. Account access takes up to 24 hours rather than being instant, because every order is checked and updated against the latest sources before it is delivered.
$199 one-time. Approximately 3 hours per module, or 36 hours total, designed to be completed at your pace over 8–12 weeks..

Within 24 hours your account in the learning environment is provisioned and the tailored implementation playbook is delivered alongside it.

30-day money-back guarantee·Know your weakest area today·210 scored questions·Course included· Account access within 24 hours
30-day money-back guarantee, no questions asked.
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