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Over the past several years, patients repeatedly told registrars at Bay Care Health System a Tampa, FL-based system consisting of 11 not-for-profit hospitals, outpatient facilities, and services that they were concerned about medical identity theft. They didn't want to provide sensitive identifying information, such as Social Security number, each time they accessed the facility.
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It sounds fairly cut and dried: If an authorization isn't obtained from a payer, the claim will be denied. However, payer requirements are getting more and more complex and stringent.
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Without question, the mistakes made by front-end staff can make or break the success of your patient access department. "Registration is one of the important components of patient care," says Debra A. Artwell, manager of outpatient access at Pennsylvania Hospital, part of the University of Pennsylvania Health System. "The patient demographics and financial information are data that follow the patient throughout our entire health system."
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If a patient becomes upset about the amount he or she will owe, Joseph Ianelli, senior financial manager of Boston-based Massachusetts General Hospital's admitting department, says that the message patient access staff want to give is: "There is something we can do for you. We want you to get the medical care you need."
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Are you certain the patient's insurance is actually active? The earlier in the process you learn this information, the more likely you are to avoid bad debt.
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Uncollectible funds, or "bad debt," is a problem your patient access department can't afford to ignore. With increasing numbers of self-pay, uninsured, and underinsured patients access managers should revamp processes sooner rather than later.
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A hospital discharge program that has social workers make follow-up calls to patients is designed to address patients' psychosocial needs and issues, as well as their medical ones.
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When Carol Cordy, MD, has a concern about a patient, she often asks a nurse to follow up with a phone call to make sure the patient is doing well and to answer any questions or concerns.