It is easier with a smaller center....however, we (the clinical coordinators) meet with our financial coordinator every two weeks to go over all the patients (about 300).  This helps us both to make sure patient statuses are where they should be and serves as a double check for the clinical coordinators to follow up on patients who are on medical hold, workup, etc.  We also have excellent relationships with our dialysis units and their social workers who keep us updated on the patients regularly.