Access Management
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Denials Categorized Based on Complexity
Some denials can be overturned easily — maybe a piece of clinical documentation is missing. Other denials are a long shot, requiring lots of time and effort to challenge. For one Philadelphia-based health system, no mountain is too high to climb.
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Revamped Tactics Needed to Overturn Surge of Denied Claims
Forced to invest significant resources trying to overturn all these denials, patient access departments are searching for the most efficient and effective way to do it.
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COVID-19 Pandemic Put Pioneering Capacity Command Center to the Test
No knew the world would be in the grips of COVID-19 in 2016. That is when Johns Hopkins Hospital unveiled a first-of-its-kind Capacity Command Center (CCC), a high-tech control room designed to apply all the latest analytical tools to bed management, patient transfers, and surge planning. CCC leaders have spent the last five years working around the clock to optimize patient flow and anticipate any potential bottlenecks. But there is no question the concept has been put to the test by pandemic conditions. How did it fare?
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Survey: Prior Authorization Hassles Persisted Mostly Unabated Through 2020
A public health emergency did not seem to remove many bureaucratic roadblocks, to the frustration of U.S. physicians.
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FDA Lifts Restriction on Mifepristone Access
Federal rule had required women to pick up the drug in person only, even during the COVID-19 pandemic.
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HCAHPS, Other Satisfaction Scores May Suffer from COVID-19 Effects
Before the pandemic, 73% of patients surveyed said they were very satisfied with the communication with their healthcare providers. During the pandemic, that figure nosedived to 60%. The number of patients who said they were not satisfied at all tripled.
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Many Patients Worry About Hospital Bill During ED Visit
To prevent EMTALA problems, train staff well, giving them carefully drafted scripts to use for patients who insist on discussing insurance coverage before a medical screening exam.
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Copay Collection Cannot Delay Care, or Hospital Risks EMTALA Violation
Registrars should bring up payment or insurance only after a medical screening exam and stabilizing treatment has been provided. This means a patient should not be asked about copays or payment during the exam or while undergoing treatment.
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Financial Counselors Find Unmet Needs at Vaccine Clinics
Everyone has to wait 15 minutes after receiving their COVID-19 vaccine. Financial counselors at Spectrum Health make good use of this time.
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Patient Access Technology Evolving to Meet Customer Expectations
Artificial intelligence, machine learning, and predictive analytics all are available. Slowness to adopt these new tools stalls progress on a better registration experience.