Hospital Access Management
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Health Plans Want Proof It Was Necessary to Admit Patient
Work with utilization managers to understand why these denials are happening. Ensure clinical documentation is detailed enough to support inpatient level of care, and be sure to submit such evidence to the health plan while patients still are in house.
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Revenue Cycle Staff Keeps ‘Financial Toxicity’ from Harming Patients
Patients often are left alone to navigate the complex healthcare system, which can cause problems. The most successful financial navigation programs direct healthcare providers and staff to work together to address patients’ needs from the time they enter the system to after discharge.
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Consumers May Be Unaware Price Information Is Available
Patients say they want price transparency, but many are completely unaware of what information is out there, and have no idea how to find it, at least in one state.
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Instant Gratification with Self-Service Price Estimators? Not So Fast, Says Patient Access
Beware the pitfalls of do-it-yourself healthcare pricing research.
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Price Transparency Now a Reality; Not All Hospitals Fully on Board
Some hospitals were holding off, hoping courts would overturn the requirements. Other facilities still are contending with operational challenges caused by COVID-19. Nevertheless, expectations have changed — and the consequences of noncompliance are real.
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Ongoing Noncompliance Leads to Serious Settlement for Small Clinic
Regardless of the size of a healthcare operation, the government will administer punishment for regulatory violations, especially if those errors stem from the facility's careless oversight.
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Right of Access Initiative Yields Major Settlements with OCR
Much confusion remains about when healthcare entities can and cannot release information under HIPAA. There are some lessons to be learned from recent enforcement actions.
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Keep Onsite and Remote Patient Access Staff Connected
Although nothing can replace face-to-face interactions, leaders are trying to maintain strong employee connections through virtual interactions, both professional and social.
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Patient Access Makes Progress Toward Fully Automated Auths
It takes creativity and time to fully automate, but the dividends make this a worthy effort.
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New Best Practices for Resolving Patients’ Medical Bills
The last thing patients need in today's climate is to deal with spiteful lawsuits and haranguing collection agencies. Recently released guidance can help patient access be helpful partners for those who need to settle medical bills.