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A well-prepared team that understands roles and responsibilities when a notice of a HIPAA compliance audit is received is essential for every organization and should be established long before a notice is received, suggests Chris Apgar, CISSP, president of Apgar & Associates, a Portland, OR-based consulting firm. Educate them about the purpose of the audit, and give each person specific responsibilities, he says.
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The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS) have issue Notices of Proposed Rulemaking that are open for comment until May 7, 2012.
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Patient access leaders at St. Elizabeth Community Hospital in Red Bluff, CA, are improving satisfaction by using feedback from newly created "transformational care" teams.
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Registrars at Sarasota (FL) Memorial Health Care System have gotten very good at calculating estimates manually, but the department is implementing a price estimation tool to make the job much easier, says Diane C. Settle, CPA, CHFP, executive director of revenue cycle.
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A new pre-arrival unit at University of Mississippi Health Care in Clinton has revamped the authorization process for services that are pending authorization, reports Sylvia Greer, MBA, associate director of revenue cycle management. The hospital has obtained $150 million in revenue for reimbursable services, she adds, many of which would have otherwise been denied by payers.
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The initial notice of audit from the Department of Health and Human Services' Office for Civil Rights (OCR) asks for a significant amount of documentation and information to be submitted within 10 days of the notice date, but that will not be the end of information for which you'll be asked, says Mac McMillan, chief executive officer of CynergisTek, an information technology security consulting company, who advised a Texas hospital included in the initial audits.
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Two years ago, patient access leaders at Hackensack (NJ) University Medical Center "had everyone doing everything," says Anne Goodwill Pritchett, MPA, FHFMA, vice president of patient financial services. "We found that for us, that was not the best way to do it."
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When Diane C. Settle, CPA, CHFP, became executive director of revenue cycle at Sarasota (FL) Memorial Health Care System in 2005, no upfront cash collection was done at all.
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Registrars at St. Luke's Episcopal Hospital in Houston, TX, are using a tool to validate a patient's identity using name, date of birth, address, and social security number during the registration process, reports Na Toshia Joseph, manager of patient access services/quality and process improvement.
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Often, physician offices aren't aware of the differences between hospital insurance requirements and provider requirements, which creates tension between the two areas, says Kellie Hawkins, director of patient access for Shady Grove Adventist Hospital in Rockville, MD.
