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New 2010 Amendments to the Federal Sentencing Guidelines and Dodd-Frank Wall Street Reform and Consumer Protection Act ("Dodd-Frank Act") make clear that prosecutors and regulators expect to see an effective compliance program that protects whistleblowers, including risk managers, says Reid Bowman, JD, general counsel with ELT Inc., a San Francisco company that provides compliance and ethics training.
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Here is a payment plan matrix for self-pay patients used by patient access staff at Skaggs Regional Medical Center in Branson, MO.
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Here is a payment planÿ
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If registrars are more accurate when completing registrations, fewer claims denials will result. This clearly improves your hospital's fiscal situation, but remains a daunting challenge for many patient access departments. Here are some steps taken by the patient access department at St. Joseph's Hospital Health Center in Syracuse, NY:
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Carmen Arroyo, clinic operations manager of cardiology, nephrology, and pulmonary medicine at Children's National Medical Center in Washington, DC, set a goal to increase her area's time-of-service collections by 9% over the previous fiscal year. She wound up tripling the amount collected. Here is how she did it:
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Point-of-service collections are becoming increasingly important for patient access areas for many reasons, but this revenue doesn't come easily.
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Registration accuracy is always a foremost concern for patient access leaders, as problems in this area can lead to needless claims denials; ineffective quality assurance audits, however, won't get results, says Diane E. Mastalski, CHAA, CHAM, Virtua's corporate director of patient access.
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More than ever, patient access staff are being challenged to step into a new role that of financial counselor. Patients have more complex questions and needs, and are turning to front-line staff for answers.
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The below proposal was submitted by John E. Kivimaki, director of patient accounts at Mary Rutan Hospital in Bellefontaine, OH, to identify areas in the revenue cycle where losses could be reduced by focusing on upfront efforts. It was accepted by the hospital's administration, and implementation is underway.