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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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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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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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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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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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Here is a payment planÿ
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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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The Centers for Medicare & Medicaid Services (CMS), on the march to value-based purchasing and tying quality care to reimbursement levels, certainly will be requiring more and more from hospitals.
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Just as it standardized clinician-to-clinician hand-offs, Kaiser Permanente recognized the importance of the hand-off for the patient from hospital to home.