News Briefs

Take a practical approach to 21st century access

A jointly sponsored conference of the National Association of Healthcare Access Management (NAHAM) and the American Association of Healthcare Administrative Management is scheduled for Oct. 11-13 at the Renaissance Hotel in Washington, DC. The conference, called "A Capital Vision: Practical Approaches to Patient Access and Accounts Management in the 21st Century," is expected to draw more than 800 attendees, according to NAHAM officials.

There will be two educational tracks — patient access services and patient financial services — covering 24 concurrent workshops over three days. In addition to the concurrent workshops, three general sessions will be offered, and there will be opportunities for networking, sharing experiences and ideas, and socializing.

The conference also will offer participants the opportunity to earn recertification contact hours and nursing credits and to take the certified hospital access manager certification examination.

For details, call NAHAM at (202) 857-1125 or e-mail info@naham.org.


OIG software report looks at claims risks

Although Medicare claims software written for commercial distribution to a large audience poses little risk of producing erroneous or false claims, proprietary software appears more likely to pose some risk of misuse or fraudulent use, according to a report released by the Office of the Inspector General (OIG) in Washington, DC.

The OIG decided to review software literature and claim preparation processes because of the vast numbers of claims electronically submitted to Medicare. The report, "Medical Billing Software and Processes Used to Prepare Claims" (OEI-05-99-00100), found many potential problems with submission of the claims, including:

• Medicare cannot identify most of the clearinghouses and billing agencies submitting claims because most use the physician’s or medical supplier’s billing number and submitter number.

• Medicare can’t determine whether claims enter from an authorized biller’s site and computer or from unauthorized sites and computers.

• Billing companies, their employees, and employees of providers with access to patient and provider information need to access the Medicare system.

The OIG report made these recommendations:

• Identify and register all clearinghouses and third-party billers. That would provide an audit trail.

• Improve safeguards to ensure electronic claims are accepted only from authorized sites and terminals.

• Educate providers about their liability for erroneous claims submitted to Medicare using their provider numbers.


Access Feedback AM seeks benchmarks to improve preregistration

Liz Kehrer, CHAM, manager of patient access at Centegra Health System in McHenry, IL, is looking for health care facilities that have been identified as "better performers" in preregistration. "I’m looking to expand our facilities’ pre-registration services to include insurance verification, precertification, and financial counseling for scheduled services," she says. "I’m also looking to include collection at time of service."

If possible, she adds, Kehrer would like contact names for the "better performer" organizations.

[Kehrer can be reached at Centegra Health System, 4209 Medical Center Drive, McHenry, IL 60050. Telephone: (815) 759-4061. E-mail: lkehrer@centegra.com. If you would like feedback from your peers on an access issue, please contact editor Lila Moore at (520) 299-8730 or lilamoore@mindspring.com.]