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Identifying Medicaid-eligible patients is a top priority for patient access staff at The University of Tennessee Medical Center in Knoxville, reports Stephen Hovan, vice president of the revenue cycle.
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In a study recently published in The New England Journal of Medicine,1 state Medicaid expansions to cover low-income adults were significantly associated with several benefits, including reduced mortality and improved coverage, access to care, and health, as self-reported.
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When patients call and ask what a test costs, the information isnt always straightforward, says Robin Woodward, CHAM, patient access director at Riverside Regional Medical Center in Newport News, VA.
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A third of patients seen at one Arizona emergency department (ED) were uninsured, but this percentage was cut in half after a checkout process was implemented, reports Todd B. Taylor, MD, FACEP, a Phoenix, AZ-based consultant specializing in Emergency Medical Treatment and Labor Act (EMTALA) compliance.
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When speaking with a payer representative, verify eligibility first, then move on to more specific details such as service category and codes, recommends John T. Porter Jr., access denial analyst for patient financial services at Scripps Health in San Diego.
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The fact that payers almost never give a guarantee of payment prior to service and require registrars to confirm that there is no guarantee should set off warning bells when verifying coverage information, says John T. Porter Jr., access denial analyst for patient financial services at Scripps Health in San Diego, CA.
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Recently, a large payer denied a claim for a CT scan of the abdomen due to no authorization, even though a registrar previously had been told none was required.
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At Harris Health System in Houston, patient access staff identify patients who fall into the category of self-pay or under insured, but the completion of the application and follow-up is outsourced, reports Veronica Rodriguez Patricio, audit, appeals, quality assurance, and training manager for eligibility and registration services.
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The pilot testing version of the CMS survey includes the following elements on hospital employee health:
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The basic premise of worker safety is to provide layers of protection. If each layer is sufficiently flawed, the protection is compromised. That is the lesson of a recent Health Hazard Evaluation in an Arizona hospital, where 18 employees had a TB skin test conversion in 2011 and one employee developed active tuberculosis.
