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Payers are asking for more authorizations for high-dollar radiology procedures, and claims denials are resulting, reports Stephen Hovan, executive director of patient fiscal services at The University of Tennessee Medical Center in Knoxville, who adds that his department is seeing a 75% increase in authorizations for radiology processes.
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Just a couple of years ago, registrars in the emergency department (ED) at the University of Connecticut Health Center in Farmington collected only $100 to $1,000 a month in copays.
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The Access Center is the first contact that a referring physician has with the hospital, notes Bob Potter, RN, manager of access and preadmissions at University of Colorado Hospital in Aurora. "The first impression is the lasting impression," he says. "Customer service is our sole reason for existing."
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About half of the self-pay patients presenting for services at Vanderbilt University Hospital in Nashville ultimately obtain Medicaid coverage, reports Marsha Kedigh, RN, MSM, director of admitting/emergency department registration/discharge station/insurance management.
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Claims denials at The University of Tennessee Medical Center in Knoxville have increased 20% to 30%, particularly from major payers including The Blue Cross and Blue Shield Association, United Healthcare, and Humana, according to Stephen Hovan, executive director of patient fiscal services.
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A team of patient access specialists consisting of top performers, role models within the division, and lead personnel offer a wide range of expertise and experience to registrars at Carolinas HealthCare System in Charlotte, NC, reports Christina Baugh, supervisor of PRN registrars and Patient Financial Service Specialists for corporate patient access.
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If a patient complains that a registrar seemed to care only about money, or insists he or she waited way too long to be registered, Jan Fowler, director of patient accounting at Saint Vincent Health Center in Erie, PA, makes a point of meeting with the staff person involved to hear their side of it.
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The Asthma Management Program at Children's Medical Center in Dallas is a good example of a best practice in education. It received certification from The Joint Commission in 2003 for disease-specific care for pediatric asthma.
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Most patient education managers would agree that a system for documenting understanding of the teaching that takes place is important. Yet there is not a cookie-cutter method that institutions follow.
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At Barnes-Jewish Hospital's Center for Diversity and Cultural Competence, St. Louis, MO, the Daylight program trains volunteers recognized and influential women from local refugee and immigrant communities to provide to their peers culturally sensitive information about breast health and breast cancer, including early detection methods. The program has been profiled by the Agency for Healthcare Research and Quality (AHRQ).
