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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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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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While state and federal law require that non-profit hospitals provide individuals with notice of the availability of free care, patients are often unaware, and not all hospitals are compliant or consistent, says Mia Poliquin Pross, Esq., associate director of Consumers for Affordable Health Care (CAHC) in Augusta, ME.
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Were suspicious documents provided for identification? Were credit monitoring reports received? Did others report suspicions about the validity of a patient's identify?
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Access management services staff at Robert Wood Johnson University Hospital in New Brunswick, NJ, provide each patient with the hospital's charity care and reduced charge charity care notices, but they go even further to be sure patients are informed of their options, says Kathy MacGillivray, MHA, access management services director.
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Patients with large deductibles often feel patient access staff members are unreasonable to ask for the amount upfront, but what about the other side of the coin?
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Nobody ever told me financial assistance was available." This is a typical comment from patients who are struggling to pay hospital bills, reports Jessica Curtis, JD, director of Boston-based Community Catalyst's Hospital Accountability Project, a national consumer advocacy organization focusing on healthcare issues.
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It's a "tremendous victory to have something approaching universal access" as a result of the Patient Protection and Affordable Care Act, but the resulting increase in underinsured patients will pose ethical challenges for providers, according to Joseph J. Fins, MD, MACP, chief of the Division of Medical Ethics at Weill Cornell Medical College and director of medical ethics at New York Presbyterian Hospital-Weill Cornell Center in New York City.
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I can't work on Saturdays." "I can't stay late on Wednesdays." "I could never do bedside registration because I can't deal with blood or vomit."
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Do some of your employees still think that getting correct information is enough to fulfill their role in patient access, with no regard for excellent service, financial counseling, or knowledge of eligibility systems?
