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Unfortunately, healthcare costs are often the first thing that comes to mind when someone gets sick, says Elizabeth H. Broadway, CHAM, director of patient access and business services at Ochsner Health Systems Baton Rouge (LA) Region.
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Patient access employees often help patients determine eligibility for Medicaid coverage, which in many cases means lost revenue is prevented. However, patients don't always keep the coverage they obtain, even if they remain eligible.
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When hospital VIPs at Lourdes Health System in Camden, NJ, expressed concern over the fact there were so many claims denials for no authorization, Joan Braveman, corporate director of patient access, asked for data. She began studying the "no auth" denials.
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Reduced collection cost and better patient satisfaction were the two major benefits of collecting copays at the time of service that were identified by patient access leaders at Cooper University Health System in Camden, NJ.
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Continuing to emphasize the importance of discharge planning and preventing unnecessary readmissions, the Centers for Medicare & Medicaid Services (CMS) has issued a revised set of Discharge Planning Interpretive Guidelines that surveyors will use to assess a hospital's compliance with Medicare's Conditions of Participation.
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Looking for some inspirational reading that can actually help you do a better job?
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If payer claims data creates a more robust picture of the cost and quality of care provided, then more data is better. But until recently, organizations that want to make use of data were doing without anything much from the Centers for Medicare & Medicaid Services.
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It always comes down to communication, right? In an effort to further emphasize improved communications along the healthcare continuum, the Centers for Medicare & Medicaid Services (CMS) has revised its Conditions of Participation (CoPs) for discharge planning. This comes just as the organization will begin doing surveys related to discharge planning procedures.
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No one expects the wrongs of millennia to be righted overnight, but it seems as if not a lot has changed every year when the Agency for Healthcare Research and Quality (AHRQ) releases its annual report on healthcare disparities.
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It has been more than 30 years since the Centers for Medicare & Medicaid Services (CMS) moved from using a chart review process to implementation of standardized measures as a way to determine the quality of care patients receive.
