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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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Too often, patient access is an area employees come into only to get their foot in the door with a long-term goal of obtaining other medical positions in the hospital, says Vicki Lyons, patient access manager at Baptist Hospital East in Louisville, KY.
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Because of rising copays and deductibles and underinsurance, patients are getting hit with bigger balances that they don't expect. More and more, patients want to know up front what they will owe.
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The shift from handling verification, eligibility, and collection issues on the front end - before or during registration - is continuing, and this is good news for patient access.
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In today's down economy, increasing upfront collections is even more important for patient access departments, but it's getting harder as many patients are struggling to make ends meet, at the same time that their copays, deductibles, and co-insurances are becoming more expensive.
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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.
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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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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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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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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.
