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State insurance exchanges and the federal marketplace got off to a rough start at the beginning of October.
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It can be very hard to find a physician champion for quality improvement projects. Docs are busy there are more responsibilities, patients are sicker, days are longer, and resources are tight.
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A transplant patient at Cook Childrens Medical Center in Fort Worth, TX, was eligible for coverage with the states Children with Special Health Care Needs program, but no reimbursement was possible as funding for the program had run out.
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Patient access staff at Trinity Regional Health System Rock Island, IL put the first and last name and social security number of every self-pay patient into a verification website to see if they have Medicaid coverage.
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Patient access employees at one facility were able to increase collections by 30% by having emergency department nurses walk patients to the discharge office so copays could be collected. Collections decreased when a supportive nurse manager left the organization. Collections increased again when nursing staff was educated on the importance of copays. It took time to establish a consistent increase in collections.
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Recently, a payer denied an $18,000 claim as non-covered services at Ochsner Health System in New Orleans, but this denial was challenged by patient access leaders.
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Patient access employees are fielding more questions from patients about their insurance coverage.
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University of Pittsburgh Medical Center increased collections by 53% after an action plan was implemented, focusing on the emergency department and imaging services.
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Uncle Sam wants your doctors to go digital. And the federal government is backing up that goal by offering money to practices if they start using digital records systems.
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Physicians are continuing to adopt electronic health records (EHRs) at a steady pace.