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Hospital Access Management – May 1, 2012

May 1, 2012

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  • Warning! Accreditation surveyors may talk with patient access staff

    Any staff member with patient contact, including those who perform a registration function, might be approached during a survey by The Joint Commission, according to Cynthia Leslie, RN, associate director of The Joint Commission's Standards Interpretation Group.
  • Involve registrars in advanced directives

    Members of the patient access staff at Catholic Health Initiatives Nebraska now play a role in complying with The Joint Commission's requirement that patients be offered educational materials on advanced directives when they are admitted, says Lauree M. Miller, director of patient access.
  • You must be involved in survey preparation

    When Lauree M. Miller, director of patient access at Catholic Health Initiatives Nebraska in Lincoln, became the organization's coordinator of admissions, patient access didn't have anyone represented on the hospital's committee that oversees accreditation by The Joint Commission.
  • Surveyors may ask this list of questions

    Below are examples of questions used to prepare registrars at Catholic Health Initiatives facilities in Nebraska for surveys by The Joint Commission:
  • Collections soar: $4.4 to $8.3 million

    When Diane C. Settle, CPA, CHFP, became executive director of revenue cycle at Sarasota (FL) Memorial Health Care System in 2005, no upfront cash collection was done at all.
  • New tool may mean 25% more collected

    Registrars at Sarasota (FL) Memorial Health Care System have gotten very good at calculating estimates manually, but the department is implementing a price estimation tool to make the job much easier, says Diane C. Settle, CPA, CHFP, executive director of revenue cycle.
  • $150M in charges paid due to process

    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.
  • Alert! Access areas at high risk for fraud

    Could a patient standing in front of you be using another patient's ID and insurance to obtain care? Is someone stealing a patient's information to obtain credit fraudulently? These areas are the primary risk in registration areas, according to Dan Schulte, executive vice president of revenue cycle solutions at The Outsource Group in St. Louis, MO.
  • Check security of 'up front' areas

    Unintentional fraud can take many forms in patient access areas, including some involving protected health information (PHI), says Dan Schulte, executive vice president of revenue cycle solutions at The Outsource Group in St. Louis, MO.
  • Validate patient info at registration

    Registrars at St. Luke's Episcopal Hospital in Houston, TX, are using a tool to validate a patient's identity using name, date of birth, address, and social security number during the registration process, reports Na Toshia Joseph, manager of patient access services/quality and process improvement.
  • Win the loyalty of physician offices

    Often, physician offices aren't aware of the differences between hospital insurance requirements and provider requirements, which creates tension between the two areas, says Kellie Hawkins, director of patient access for Shady Grove Adventist Hospital in Rockville, MD.
  • Teach providers about your role

    Take the time to provide training to provider offices about insurance guidelines and registration processes, because this training is a good way to encourage collaboration with patient access, recommends Kellie Hawkins, director of patient access for Shady Grove Adventist Hospital in Rockville, MD.
  • Need a solution? Just ask your staff

    Patient access leaders at St. Elizabeth Community Hospital in Red Bluff, CA, are improving satisfaction by using feedback from newly created "transformational care" teams.
  • Employees differ in training needs

    If you stick to one teaching style for all of your patient access staff, this process can result in poor morale, warns Tracy Abdalla, assistant manager of hospital access services at University of California -- Davis Medical Center Hospital.
  • Use QA tool to train staff

    A patient access employee working in central admitting has different training needs from someone working in radiology, the emergency department, or same-day surgery.
  • Staff members' roles are made more specific

    Two years ago, patient access leaders at Hackensack (NJ) University Medical Center "had everyone doing everything," says Anne Goodwill Pritchett, MPA, FHFMA, vice president of patient financial services. "We found that for us, that was not the best way to do it."
  • HIPAA Regulatory Alert: HIPAA compliance audits begin with a pilot program

    As promised by the Department of Health and Human Services' Office for Civil Rights (OCR) and mandated by the HITECH Act, HIPAA compliance audits have begun, and 20 organizations were visited during the pilot phase of the program.
  • HIPAA Regulatory Alert: Get these documents ready for an audit

    Although there is no way to know exactly what documents you will be asked to provide in the initial HIPAA compliance audit notice from the Department of Health and Human Services' Office for Civil Rights (OCR) there are some items you can expect to see on the list, according to experts interviewed by HIPAA Regulatory Alert:
  • HIPAA Regulatory Alert: What can you expect when auditors arrive?

    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.
  • HIPAA Regulatory Alert: Do now: Set up in-house audit team

    A well-prepared team that understands roles and responsibilities when a notice of a HIPAA compliance audit is received is essential for every organization and should be established long before a notice is received, suggests Chris Apgar, CISSP, president of Apgar & Associates, a Portland, OR-based consulting firm. Educate them about the purpose of the audit, and give each person specific responsibilities, he says.
  • HIPAA Regulatory Alert: Proposed rules published for stage 2 meaningful use

    The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS) have issue Notices of Proposed Rulemaking that are open for comment until May 7, 2012.
  • HIPAA Regulatory Alert: Consumer privacy is subject of FTC report

    The Federal Trade Commission (FTC) has issued a final report outlining best practices for businesses to protect the privacy of American consumers and give them greater control over the collection and use of their personal data.