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Access Management

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  • Access descriptions are likely outdated

    Until recently, members of the patient access staff at St. Joseph's Hospital Health Center in Syracuse, NY, were assigned a generic "customer service representative" title that didn't reflect what they actually did.
  • Can you text patient about appointments?

    Many patients are accustomed to receiving text messages from friends, retailers, and workplaces, and they probably expect to be able to receive texts from you.
  • Denials cut from $200K to $50K

    Because the findings were unclear on an abdominal and pelvic sonogram performed for a patient at Cook Children's Medical Center in Fort Worth, TX, the radiologist performed a CT scan of the abdomen and pelvis with contrast, but this additional test hadn't been authorized by the payer.
  • Is insurance valid? Process is high-tech

    Not long ago, a registrar would assume a patient was providing accurate information, only to find out the claim was denied due to incorrect insurance, reports Michelle M. Mohrbach, CHAM, manager of patient access and central scheduling at Blanchard Valley Health System in Findlay, OH.
  • Patients are price shopping: They'll want more than just `guesstimates'

    A patient wasn't happy with the answer she received after asking registrars at Botsford Hospital in Farmington Hills, MI, the cost of a high-dollar procedure, and she insisted that she could get it performed for half of the price quoted.
  • Patient questions are getting tougher

    Will my insurance cover this visit?" is something patients often ask registrars in the emergency department at Sutter Delta Medical Center in Antioch, CA. However, the answer isn't as simple as it seems.
  • 'Safe Count' effort aimed at overlooked items in delivery

    Retained objects are a constant worry in any invasive procedure, but the risk has gone overlooked in obstetrics. A project from the Minnesota Health Association (MHA) is changing that situation and has practically eliminated the problem statewide.
  • End-stage renal disease care cited in OIG’s Work Plan

    The Office of the Inspector General (OIG) recently released its Work Plan for the fiscal year 2013, giving risk managers a heads-up about what topics will be of most interest to regulators over the next year. Some are perennial favorites, such as fraud and abuse, but there are many new areas of focus for 2013.
  • Senator questions hospitals over 340B drug funds

    Sen. Chuck Grassley (R-Iowa) is asking three North Carolina hospitals to explain their use of a federal discount drug program after news reports described how the hospitals charge their patients a big mark-up on certain drugs, such as cancer-fighting drugs.
  • Transition to accountable care brings major risks

    The healthcare industrys transition to accountable care will require significant cultural and operational shifts, bringing new risks that many organizations have yet to fully identify and manage, according to a new white paper from Marsh, the insurance broker and risk management consulting practice based in New York City.