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Ask passersby in a hospital hallway what they think the biggest problem is in the emergency department, and one of the most common answers will likely be something about the influx of uninsured patients who use the ED as their primary care physician.
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A patient recently registered at Denver-based Porter Adventist Hospital had just lost his job and employer-sponsored insurance, and he was under the mistaken impression that COBRA coverage was automatic.
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Since copayments first were collected in Cambridge (MA) Health Alliance’s three emergency departments (EDs) in October 2008, collections have increased 140%, totaling $173,000 in fiscal year 2009 to an expected $416,000 in fiscal year 2012.
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When patient access leaders had to select a subject for the first e-learning module developed at St. Luke’s University Health Network in Allentown, PA, they chose computer downtime procedures
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While a small group of registrars at Legacy Health in Portland, OR, were effective collectors, and most were trying their hardest, about one-third weren’t making much of an effort to collect anything at all.
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Previously, it took some patient access employees over an hour to travel up to 40 miles to a training site for required education at St. Luke’s University Health Network in Allentown, PA. Now, employees can take some of the training right from home or at their current facility.
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We are now receiving denials for failing to obtain authorization for the medication in those injections. This is something we had not seen previously,” reports Jeanette Foulk, director of patient access at Methodist Charlton Medical Center in Dallas.
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Registrars might learn more information after asking patients with inactive coverage, “While reviewing your insurance, we are getting notification that you have another primary payer. Do you have any other insurance?
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Patients might tell a registrar that they still have a Medicare Advantage plan when they no longer do, that they do not have supplement A & B coverage when they actually do, or that they have Medicare for disability coverage when it is really for end stage renal disease.
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If a patient is admitted on a holiday or after normal business hours and registrars are unable to notify the payer until the next business day, the claim could be denied for late notification, warns Jeanette Foulk, director of patient access at Methodist Charlton Medical Center in Dallas.
