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Benefits exhausted, coverage not in effect at the time of service, patient ineligible at the time of service, no authorization prior to service, and patient unidentified. Each of these reasons for a denied claim is different, but the result is the same - the hospital doesn't collect. And in today's economy, this spells trouble for patient access departments.
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Cutting delays in the registration process can free up patient access staff and make patients more satisfied, but this can be challenging.
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Technology tools that facilitate the capture and communication of data are essential for patient access, but there is a downside. "The scary part is that systems today have the capacity and structure to get bad data out faster, and can do a lot of damage if not managed or used correctly," says Kathryn Stevens, PhD, MBA, CHAM, northwest regional delegate for the National Association of Healthcare Access Management.
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Currently, Methodist Le Bonheur Healthcare in Memphis, TN, is "in the infant stage" when it comes to being able to quote prices to patients through its web site, says Jessica Murphy, CPAM, corporate director for patient access services. "But we have done a good bit of research, and believe when we do this it will be a useful product," she says.
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If your hospital is like most, patients admitted through the emergency department are being held, possibly in hallways, for hours and even days. It's a complicated problem that the patient access department isn't responsible for and can't control. Still, you bear the brunt of the poor customer service scores that result from this situation.
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After an electronic ordering process was implemented at Bon Secours Hampton Roads Health System in Marriottsville, MD, the central scheduling department stopped "pulling their hair out" looking for misplaced or inaccurate orders.
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Allowing patients the option of pre-registering online is good for patient satisfaction and also frees up patient access staff for those who prefer to speak with a representative.
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A career ladder has helped the patient access department at Palmetto Health Richland in Columbia, SC, to "build our own leaders," says Charlene B. Cathcart, CHAM, director of admissions and registration.
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Patient access staff will have to get used to a change for Medicare patients, with the new Advance Beneficiary Notice of Noncoverage (ABN) form now used for all situations where Medicare payment is expected to be denied. The form, implemented by the Centers for Medicaid & Medicare Services (CMS), becomes mandatory March 1, 2009.
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When administrators at Shands at the University of Florida in Gainesville asked his opinion about how they could increase point-of-service (POS) collections, Tim Carney, manager of outpatient financial arrangements, told them in no uncertain terms that decentralization was the key.
