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Create ‘culture of privacy’ in patient access areas
To prevent potential violations of the Health Insurance Portability and Accountability Act, “we need to, first, cultivate a culture of privacy within the patient access staff,” says Julie Johnson, CHAM, FHAM, director of patient access and Health Information Management and HIPAA privacy officer at Mount Graham Regional Medical Center in Safford, AZ.
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Common registration practices cause big problems with HIPAA
“Mr. Bob Jones? Your colonoscopy will take place in 15 minutes.”
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Prevent denials in the first place — Training is ‘paramount’
Errors or typos made by registrars during the collection of information or during the data entry process are “extremely prevalent” in claims denials, according to Brinn Leach-Wilson, a Merritt Island, FL-based consultant with BHM Healthcare Solutions.
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Payers claim procedures weren’t medically necessary
With medical necessity denials, “prior authorization is ‘job-one,’” says John Holyoak, director of product management at RelayHealth Financial, which is based in Alpharetta, GA.
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Did payer deny claim? Look closely to see if contract allows it
Many patient access leaders are seeing a sharp increase in claims denials, primarily due to more numerous and stringent payer requirements.
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TJC, CDC collaborate on infection prevention project
The Joint Commission and the Centers for Disease Control and Prevention are collaborating on an initiative to disseminate CDC guidance related to infection prevention and control in ambulatory settings.
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AAAHC has new standard requiring written risk assessment for infection control
Beginning this year, the Accreditation Association for Ambulatory Health Care has a new standard (7.I.B.) requiring a written risk assessment in infection control. The risk assessment becomes the basis for the infection control program for the facility, according to Marcia Patrick, MSN, RN, CIC, surveyor for ambulatory care at AAAHC.
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Staying survey-ready is critical in current accreditation environment
A cautionary note: Those days of knowing when surveyors or government regulators are coming and having time to prepare? They’re long past, say accreditation experts interviewed by Same-Day Surgery.
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No link found between anesthesia after age 40 and mild cognitive impairment
A study of people who received anesthesia for surgery after age 40 found no association between the anesthesia and development of mild cognitive impairment later in life. The study was conducted by the Mayo Clinic in Rochester, MN.
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Colonoscopy quality varies among facilities
Researchers have found important variation in quality of colonoscopies among outpatient facilities.