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Payers are asking for more preauthorizations, even for services that previously didn't require them, reports Connie Campbell, director of patient access of Mercy Medical Center in Oshkosh, WI.
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When a patient asks what he or she will owe for a procedure, registrars at St. Joseph's Healthcare System in Paterson, NJ, consider the payer contract, procedure code, procedure amount, and patient benefits, says Sandra N. Rivera, RN, BSN, CHAM, director of patient access.
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How much will I owe for this procedure?" Your response to this seemingly simple question from a patient could be the deciding factor as to whether he or she chooses your facility, says Marcy Quattrochi, manager of financial counseling at NorthShore University HealthSystem in Evanston, IL.
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Rewarding your overall patient access team for ED collections is a more practical approach than rewarding individual staff members, according to Cindy Geaslin, director of patient registration at NorthShore University HealthSystem in Evanston, IL.
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No one ever asked me for money before," was a common response when registrars started collecting ED copays at Evanston, IL-based NorthShore University HealthSystem, reports Cindy Geaslin, director of patient registration.
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At Valley Health System in Ridgewood, NJ, two major goals are to obtain more authorizations and to do them in advance of the inpatient stay or procedure, says Maura Corvino, MSOL, RN, CEN, assistant vice president for emergency services and patient access.
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After working with a consultant to determine how to improve clinical documentation, the care coordination department at Wake Forest Baptist Medical Center in Winston-Salem, NC, revamped its clinical documentation program, adding more staff and shifting the team from unit-based to service-based.
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When Stony Brook University Medical Center presented an educational program to its urology staff about the importance of using the correct terms in documentation, the physicians pointed out that in medical school, they learned to write "urosepsis" on the chart for patients who had developed sepsis from a severe urinary tract infection, according to Catherine Morris, RN, MS, CCM, CMAC, executive director of care management and clinical documentation improvement administrator at the 591-bed regional hospital in Stony Brook, NY.
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The report card that begins below is an example of a method for aggregating and reporting all the measures that we have reviewed in the last two issues.
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As reform helps more Americans gain access to health coverage, experts predict that the nation's EDs will be bulging at the seams.