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While some authorizations are straightforward, others can be complex and result in claims denials, according to Alicia Alampi, manager of patient access at St. Joseph's Hospital in Syracuse, NY.
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A certain group of experienced access representatives were chosen to participate in an emergency department (ED) copay collection pilot at Middlesex Hospital in Middletown, CT, reports Margaret Trudel, patient access manager. This team was successful in substantially increasing copay collections in the ED.
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"I've already been asked for that information 100 times. Why are you asking me again?"
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Patient access staff at Methodist Hospital in Kalamazoo, MI, are assessed for customer service as part of the criteria for the hospital's bonus program, says Patti Burchett, director of registration and central scheduling.
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When patient access leaders at Cincinnati (OH) Children's Hospital Medical Center took a close look at multidisciplinary clinics, it was determined that many of them were collecting a single co-pay even when patients saw multiple providers, says Michelle Gray, MHA, director of patient access and outpatient registration.
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Registrars at Cincinnati (OH) Children's Hospital Medical Center now have an added incentive to obtain co-pays: It could determine the amount of their pay increase.
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Martin Memorial Health Systems in Stuart, FL, reports an increase in authorization requirements for inpatient and outpatient accounts.
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After patient access staff at UNC Health Care in Chapel Hill, NC, began receiving bi-weekly reports on how much they collected, their performance began to improve.
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When a new emergency department (ED) bedside co-pay collection process was implemented at Middlesex Hospital in Middletown, CT, access reps were "very, very nervous about what the reaction was going to be," recalls Margaret Trudel, patient access manager.
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Claims denials often occurred because the patient's disposition didn't match up with what the Centers for Medicare & Medicaid Services (CMS) required to authorize a procedure, reports Maura Corvino, MSOL, RN, CEN, assistant vice president for emergency services and patient access at Valley Health System in Ridgewood, NJ.
