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The ED verification staff, registration staff, case managers, emergency nurses, and a group of patients joined together and brainstormed ideas at Bronson Methodist Hospital in Kalamazoo, MI, with the goals of reducing denials, obtaining a better understanding of each other's roles, and obtaining accurate demographics, says Tina Nadrasik, patient access manager over the ED. Here are three areas that were identified:
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Sick, upset, and distracted patients often gave inaccurate or incomplete information to registration staff in the ED at Bronson Methodist Hospital in Kalamazoo, MI, notes Tina Nadrasik, the department's Patient Access manager. This problem sometimes resulted in claims denials, she adds.
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It's taken a collaborative effort between patient access and provider offices to navigate the challenges of prior authorization and payer requirements, while continuing to give patients an excellent experience, says Adrienne Pinelle, CHAA, manager of the preauthorization team for patient access services at University of Utah Health Care in Salt Lake City.
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With payer requirements becoming more numerous, patient access departments face an ongoing battle to keep staff current.
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Because the prior authorization process occurs well in advance of a service, your Patient access staff will need to be prepared for ICD-10 well before the Oct. 1, 2013, implementation date, warns Rennae J. Glidden, RHIT, director of data services at HealthEast Care System Midway Campus in St. Paul, MN. Use these strategies:
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Your current systems will need to be remediated if they will be used to check medical necessity for ICD-10 standards when they are implemented in October 2013, says Jeffrey Smith, RN, MBA, CPC, a New York City-based manager at Accenture Insight Driven Health, a management and technology consulting company.
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It is notoriously difficult to convince surgeons to change their methods and tools in the operating room to improve sharps safety. But in Tennessee, intransigence is apt to lead to a citation from the Tennessee Occupational Safety and Health Administration.
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Everyone agrees that health care workers should receive the influenza vaccine each year to protect themselves and their patients.
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Cindy Luebbering, RN, a senior health systems manager and occupational health nurse at the Cincinnati, OH-based Proctor & Gamble Company, says that her goal is to give employees information on how to get healthy, stay healthy, and how to live a full and healthy life if diagnosed with a health condition."
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If an employee reports shoulder soreness, this could be caused by her job, sports activities she does on weekends, or both. "Risk factors and the mechanism of injury are often both unclear with repetitive strain injuries," says Susan Murphey, BS, CECD, president of Essential WorkWellness in Shoreline, WA.
