Hospital Access Management – July 1, 2014
July 1, 2014
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Respond to these ACA problems — Access must revamp processes
Due to changes resulting from the Affordable Care Act, patient access departments need revamped processes to prevent the following: claims denials, increased wait times, and patient dissatisfaction. -
‘Doctor, how much will that cost me?’
Patient access departments are moving the financial counseling process to the point of scheduling and helping providers to address patients concerns about the cost of care. -
Revamp process for financial counseling
Previously, all financial counseling at Virginia Mason Medical Center in Seattle was done on the hospitals main campus. It wasnt offered at the organizations seven outpatient medical clinics. -
Payers are shifting liability to patient
Hospitals bad debt is expected to increase due to such factors as higher out-of-pocket costs and failure of patients to pay plan premiums. Patient access can minimize bad debt by doing the following: -
Take these steps to reduce bad debt
Dramatic changes in healthcare are a call to action for patient access, warns Katherine H. Murphy, CHAM, vice president of revenue cycle consulting in the Oakbrook Terrace, IL, office of Passport, part of Experian, a provider of technology for hospitals and healthcare providers. -
Face denials if you don’t ID right `exchange’ plan
Claims denials will result if patient access staff incorrectly identify the correct payer when patients present with coverage obtained on the Health Insurance Exchange Marketplace. -
Out-of-network plans must be identified
Wheaton Franciscan Healthcare in Glendale, WI, is participating in only two of the plans available on the Health Insurance Exchange Marketplace. -
Give access staff a `visual’ for plans
Patient access leaders at The University of Texas M.D. Anderson Cancer Center in Houston created a visual tool in 2013 to help staff to determine the correct payer. -
Access departments might be non-compliant
Patient access departments need revamped processes to be sure patients are informed of available financial assistance, to comply with a proposed rule from the Internal Revenue Service. -
Are collection efforts by your staff abusive?
Are uninsured patients billed at a higher rate than insured patients? -
Beef up your processes for discharge planning
As the Centers for Medicare & Medicaid Services (CMS) continues its emphasis on discharge planning, its more important than ever to create a comprehensive discharge plan that provides everything patients need to manage in the next level of care, some experts say.