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Hospitals are left in an untenable position due to changes in policy by the Centers for Medicare and Medicaid Services (CMS) that are causing hospitals to place patients in observation status for more than 48 hours instead of admitting them, according to an April 27, 2012, amicus brief filed by the American Hospital Association (AHA).
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Have community advisory groups give feedback not only on clinical processes, but also the revenue cycle, advises Richard L. Gundling, FHFMA, CMA, vice president of healthcare financial practices for the Healthcare Financial Management Association (HFMA).
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Patient access departments need to prepare for a “great increase” in the volume of patients who are eligible not only for Medicaid, but also private insurance policies, as a result of the Patient Protection and Affordable Care Act (PPACA) according to Luis Guerrero, director of patient access services at Ochsner Baptist Medical Center in New Orleans.
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Emergency department (ED) copay collections increased 20% after a process was implemented at Washington Adventist Hospital in Takoma Park, MD, that required patient access reps to perform a benefit check on patients presenting with insurance.
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Medicare patients often are shocked to learn that they have a significant out-of-pocket responsibility due to being in observation status instead of inpatient, reports Diane C. Settle, CPA, CHFP, executive director of the revenue cycle at Sarasota (FL) Memorial Health Care System.
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Patients are asking patient access staff for various self-service options for registration processes, including price estimates, reports Angela Long, associate vice president of administrative services in revenue management at Geisinger Health System in Danville, PA.
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Jamie Kennedy, a patient access supervisor at Ohio State University East Hospitals ambulatory clinic, says that her clinic is hiring additional staff, and customer service is her number one priority.
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There is a growing emphasis on sensitivity in hospital collections that patient access staff should be aware of, advises Richard L. Gundling, FHFMA, CMA, vice president of healthcare financial practices for the Healthcare Financial Management Association (HFMA).
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Patient access staff at Methodist Charlton Medical Center in Dallas now run all self-pay patients through an automated verification system to identify those that are unaware that they are still active with the Medicaid program.
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Self-pay accounts receivable (A/R) was reduced by about $15 million annually after the patient access department at Geisinger Health System in Danville, PA, implemented daily eligibility checking of self-pay accounts against Medicare and Medicaid to find instances in which patients had coverage for that particular date of service.
