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It's taken a collaborative effort between patient access and provider offices to navigate the challenges of prior authorization and payer requirements, while continuing to give patients an excellent experience, says Adrienne Pinelle, CHAA, manager of the preauthorization team for patient access services at University of Utah Health Care in Salt Lake City.
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With payer requirements becoming more numerous, patient access departments face an ongoing battle to keep staff current.
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Because the prior authorization process occurs well in advance of a service, your Patient access staff will need to be prepared for ICD-10 well before the Oct. 1, 2013, implementation date, warns Rennae J. Glidden, RHIT, director of data services at HealthEast Care System Midway Campus in St. Paul, MN. Use these strategies:
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Your current systems will need to be remediated if they will be used to check medical necessity for ICD-10 standards when they are implemented in October 2013, says Jeffrey Smith, RN, MBA, CPC, a New York City-based manager at Accenture Insight Driven Health, a management and technology consulting company.
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IRB offices routinely handle protocol submissions that are incomplete or flawed in other fundamental ways. These problems cause roadblocks that slow down the IRB approval process and frustrate investigators and IRB staff alike.
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When internal job mobility is stagnated, it can result in high staff turnover rates a problem no IRB wants to experience.
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IRB professionals might not have gotten into the business of protecting human subjects because of their love for mathematics and statistics. But many now are finding that tracking data and analyzing numbers helps them do their job better.
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IRBs sometimes balk at studies that ask sensitive questions about topics such as sex and violence, based on concerns that participants may find them distressing.
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The state of Michigan has moved forward with its plan to store blood samples left over from screening newborns for medical conditions in a biorepository that will make the deidentified samples available for research.
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Investigators, particularly when they are new to human subjects research, often fail to include all necessary information in their IRB applications because they are unaware of what's required.