Hospital Access Management – June 1, 2014
June 1, 2014
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Stop surge of denied claims due to payers’ new clinical requirements
Patient access areas need revamped processes due to new payer requirements for detailed clinical information, to avoid a sudden increase in claims denials. -
Do you lack access to clinical information?
Patient access areas, especially those responsible for obtaining prior authorizations and contesting denials, must have proper access to clinical information, urges David Hoogenboom, CHAA, team lead/patient access liaison III in the Outpatient Access Department at Danbury (CT) Hospital. -
Lunch and learns educate providers
Staff members at provider offices often think, wrongly, that the hospital is responsible for obtaining or denying authorizations. -
Collections up 30% with target goals
Posting collection scores on a board in patient access areas increased upfront collections at Maury Regional Medical Center in Columbia, TN, by 30%. -
How to set collection goals
Diane Ward, assistant director of Enterprise Patient Access Services at UK Healthcare in Lexington, recently set target goals for her departments. -
You should standardize your access processes
Standardized registration processes decrease claims denials and increase success with cross-training, according to patient access leaders. Eligibility denials decreased by 14% each quarter in the last fiscal year at UK Healthcare. -
Justify need for additional FTEs
Patient access areas risk being short-staffed if leaders dont monitor patient volumes closely. -
Access area benefits from standardization
At Louisville, KY-based Baptist Healths seven hospitals, the focus on standardizing patient access and scheduling functions started two years ago, at the same time a new registration system was being implemented. -
How likely is patient to pay?
Propensity to pay software can help determine a patients ability to pay, but few patient access areas use this technology. -
Spend an hour in registration areas
By spending about an hour rounding in registration areas, patient access leaders can resolve many staff concerns and boost morale. By rounding, managers can do the following: -
Managers must act on sudden surges in volume
While rounding in an outpatient registration area at Elmhurst (IL) Memorial Healthcare, registration supervisor Gloria Vargas-Gonzalez saw that only one registrar was working, despite many patients waiting to be registered. -
Principles help consumers obtain healthcare price info
A task force made up of healthcare leaders and consumer representatives has reached consensus on how consumers can obtain clear and easy-to-understand information about their financial obligation for healthcare services, before any tests or procedures are performed. -
CMS made $7.5 million in incorrect hospital payments
The Centers for Medicare & Medicaid Services (CMS) found in its improper payment reviews for 2008 through 2011 that evaluation and management (E/M) services were frequently miscoded. -
Congress delays Medicare pay cuts
President Obama has signed the Protecting Access to Medicare Act of 2014 (H.R. 4302) into law. This law marks the 17th time Congress delayed the cuts to physician reimbursements established with the Sustainable Growth Rate (SGR) under Medicare. The bill delays a 24% cut to the payments.