Big Expectations for ‘Transparent’ Costs: Can Patient Access Meet Them?

Calls for healthcare transparency are growing louder. Smart patient access departments are heeding those calls. Several states have passed laws requiring that hospitals provide price quotes on request. Generic information isn’t enough; it must be personalized according to the patient’s insurance.

Patients Want Self-service Estimates and Exact Dollar Amounts

Price transparency and price estimates have been two critical focus areas for one hospital's financial services team for more than two decades.

Quality Assurance Dashboard Spotlights Issues

Manual processes are no longer enough to conduct the kind of quality assurance patient access leaders need.

Is Patient’s Complaint Exaggerated? Recordings Tell the Real Story

Are patient access staff explaining consent forms accurately to patients? Are they interpreting and explaining insurance benefits correctly? Face-to-face recordings of registrations let patient access leaders at one facility know these things for certain.

Auth Already in Place as Payer Requires? Claim Still Might Be Denied

Patient access diligently obtains a required authorization from the payer and the service is scheduled. Weeks later, the claim is denied. However, it is not for “no auth,” but because the payer says it was not medically necessary.

The Virtues of Real-time Registrar Observation

Patient access leaders can learn a lot from annual evaluations or soliciting feedback at staff meetings. But, sometimes, they learn even more from observing an employee during a shift.

Stop Denied Claims for Patients Discharged With Complex Needs

Some hospitalized patients have complex discharge needs. While many of these needs are clinical, patient access can help with coverage issues.

Three Key Areas of Expertise

Customer service, critical thinking, and flexibility are important skills for the ongoing success of patient access departments.

Educate Staff on Criminal Prosecution Risk

Criminal prosecutions for HIPAA violations appear to be increasing, putting both individuals and healthcare organizations at risk for more than just monetary penalties and regulatory burdens.

Federal Court Affirms No Private Right of Action

A federal judge recently affirmed that HIPAA does not provide a mechanism for individuals to sue when they believe their privacy rights have been violated. However, the decision probably will not stop individuals from thinking they have the right to sue.