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Patient access employees are fielding more questions from patients about their insurance coverage.
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Recently, a payer denied an $18,000 claim as non-covered services at Ochsner Health System in New Orleans, but this denial was challenged by patient access leaders.
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Patient access employees at one facility were able to increase collections by 30% by having emergency department nurses walk patients to the discharge office so copays could be collected. Collections decreased when a supportive nurse manager left the organization. Collections increased again when nursing staff was educated on the importance of copays. It took time to establish a consistent increase in collections.
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Patient access staff at Trinity Regional Health System Rock Island, IL put the first and last name and social security number of every self-pay patient into a verification website to see if they have Medicaid coverage.
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A transplant patient at Cook Childrens Medical Center in Fort Worth, TX, was eligible for coverage with the states Children with Special Health Care Needs program, but no reimbursement was possible as funding for the program had run out.
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Duplicate registrations decreased from 36 a month to seven, due to new processes at Childrens Hospital of Pittsburgh of UPMC. To decrease these errors, registrars should do the following: Be able to view the patient's address along with name, date of birth, and social security number. Pay close attention to details. Ask the right questions.
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Patient access leaders added mobile cell phone chargers to registration areas at Virginia Mason Medical Center after patients requested these chargers to decrease anxiety. Staff members don't have to field constant requests from patients for cell phone chargers. Patient access employees appreciate being able to use the chargers. Patient responses have been positive.
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Registrars have become much more comfortable calling clinicians with questions due to face-to-face meetings that take place at New York Presbyterian Hospital/Weill Cornell Medical Center in New York City. Bed assignment meetings begin with introductions. Registrars are seated next to triage nurses. Nurses obtain demographic information from patients presenting by ambulance.
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In the 1990s, the focus was largely on the performance of the back end of the revenue cycle. This has largely paid off, and hospital leaders have turned to the front end for further improvements, according to Ronnie Dail, managing director of Huron Healthcare in Chicago. Dail says patient access requires an increasingly integrated approach for scheduling of appointments, sharing information with clinicians, and validating coverage. Here are three processes Dail says are top priorities for patient access
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Less than 30% of patient access areas use patient liability estimator software, but this software is necessary to ensure patient satisfaction with growing numbers of underinsured and self-pay patients. Decide which tool will work best with your patient accounting or patient management system. Incorporate ability to pay functions and a presumptive charity care screen. Develop good financial policies for pre-registration and patient advocacy.
