Access Management
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Real-Time Surveys Reveal True Feelings About Registration
The patient experience is a priority for hospitals, but typical patient satisfaction surveys are not much help to revenue cycle departments. Surveys usually do not reveal which registrar is responsible for the patient’s impression. Also, some respond to every other question in the survey, but leave the registration-related question blank for some reason. To better understand the patient experience, registrars hand out “Please tell my manager how I did” cards. The idea is to encourage patients to respond right after, or even during, their registration experience.
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If CPT Code Changes, Patient Access Can Obtain Payment
Patient access can intervene to stop an unauthorized test, assuming it is not emergent or urgent — or find out if the patient wants to go forward anyway. Registrars' expertise makes all the difference on whether the hospital is paid, and how quickly. Possibly, the health plan will agree a new authorization is unnecessary — as long as the clinical records are sent with the claim.
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Revenue Depends on Correct CPT Codes; Beware Sudden Changes
The revenue loss caused by CPT code changes is nothing short of staggering. When it comes to CPT codes that change after service, one of the biggest challenges is in the surgical space. Learn how some patient access departments are proactively addressing this problem.
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Hospital at Home Model Benefits from Traditional QI Approach
The Hospital at Home care model is gaining favor with hospitals and health systems as a way to provide hospital-level care in a patient’s home while lowering costs by almost one-third and reducing complications. The approach is receiving more attention now as a way to avoid asking patients to come to the hospital during the COVID-19 pandemic.
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TJC: Quality Improvement Should Include Data Analysis on Equitable Care
The COVID-19 pandemic has put a spotlight on the substantial disparities in healthcare that have existed in the United States for many years. The Joint Commission recently issued tips for identifying healthcare disparities and addressing them.
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Data Are the Key to Avoiding Claims Denials
Claims denials have increased by 11% nationally since the onset of the COVID-19 pandemic, according to an analysis. Almost half of claims denials are caused by front-end revenue cycle issues, including registration/eligibility, authorization, or service not covered. Implementing a process to check eligibility at multiple points throughout the revenue cycle will go a long way in preventing this common denial from occurring.
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Make Patient Access Evaluations More Transparent
Just as hospitals are becoming more transparent about costs and the quality of clinical care, the same is true for revenue cycle staff performance evaluations. Staff can check on how many registrations they have completed and the accuracy of each. They also can see how the overall department is performing — speed of calls, wait time duration, and how many calls are going to voicemail.
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More Work Needed to Protect Underinsured Patients
Poor communication from insurers, a lack of understanding of what patients are purchasing contribute to problem. Early identification of underinsured patients buys time to find solutions.
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‘One-Stop Shop’ Self-Registration Is Reality for Patient Access
There is a caveat: Patients are looking for a quick, easy experience. If they do not get it, they will revert to the old, labor-intensive system.
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ED Patients Worry About the Bill, Registrars Can Intervene
People come to the ED sick, injured, or in severe pain. This is not an opportune time to ask someone for a $100 copay — or, worse, inform them they are responsible for the entire bill.