Hospital Access Management – August 1, 2011
August 1, 2011
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Have effective self-pay processes? Facility's fiscal health is at stake
Hospital stays for uninsured patients increased 21% between 2003 and 2008, according to a new report from the Agency for Healthcare Research and Quality (AHRQ). -
Action plan maximizes payment, reduces costs
Since beginning a "financial advocacy initiative," Advocate Illinois Masonic Medical Center in Chicago has seen nearly a 160% increase in its point-of-service (POS) collections. -
Population shifting to uninsured, underinsured
You might be seeing a decrease in your "financial buckets" of insured patients, and an increase in underinsured or uninsured patients, without a corresponding increase in the number of services rendered. -
Don't give patients wrong benefits info
If you tell patients they owe their entire deductible of $2,000 for an inpatient procedure, and they know that $1,700 of the deductible already was met, your credibility and competence are suddenly in question. -
No bed available? Keep patient satisfied anyway
If a worried and anxious patient or family member is kept waiting, it might help to convey the underlying reasons for delays in registration, treatment, or room placement, says Diane Manuel, director of patient access for admissions and the emergency department at Wake Forest University Baptist Medical Center in Winston Salem, NC. -
ED registrars often ID 'suspicious answers'
Some emergency department (ED) patients are destitute, drug-seeking, or have nowhere else to obtain care, and they might pass themselves off as others to obtain insurance coverage, says Marsha Kedigh, RN, MSM, director of admitting, emergency department registration, discharge station, and insurance management at Vanderbilt University Hospital in Nashville. -
Handle red flags differently in the ED
Suspected 'red flags' must be handled differently in the emergency department than other registration sites, according to Joyce L. Predmore, associate director of patient access services at Ohio State's University Hospital East in Columbus. -
Did registrar complain? It's an opportunity
Do you overhear registrars making remarks such as "We were slammed this morning!" or "We don't have enough staff today?" You'll need to re-evaluate your staffing levels to be sure the department is providing optimal coverage and customer service, says Kathleen Bowles, LSW, patient access supervisor at The Ohio State University Medical Center in Columbus. -
If registrar complains, learn this information
If a registrar complains to Kathleen Bowles, LSW, patient access supervisor at The Ohio State University Medical Center in Columbus, she begins by asking these questions: When did the incident take place? What occurred? Who was involved? What was the outcome of the situation? -
Can't do what staff are asking? Explain
The results of a survey of registration staff at University Orthopaedic Center, part of Salt Lake City-based University of Utah Health Care, were a little surprising to managers. -
80% of uninsured in ED eligible for coverage
If an individual receives an array of costly diagnostic tests in your emergency department and ends up being admitted, the patient's uninsured status doesn't necessarily mean the hospital can't receive payment for services provided. -
$550,000 of self-pays converted in one month
In a single month, registrars at Trinity Regional Health System in Rock Island, IL, were able to obtain disability coverage for five patients with a total of $450,000 in charges, and they were able to obtain Medicaid coverage for 104 patients who had received a total of $100,000 in services. -
ID both crowding and under-utilized capacity
Smoothing" occupancy over the course of a week can protect patients from crowded conditions, according to a study involving 39 children's hospitals during 2007.1 Researchers compared weekday versus weekend occupancy to determine just how much "smoothing" can reduce inpatient crowding. -
HIPAA Regulatory Alert: Proposed rule allows patients to see details of health record access
Compliance and regulatory officers have until Aug. 1 to comment on a proposed rule that includes a new accounting of disclosures provision that gives individuals the right to receive a report on who has electronically accessed their protected health information (PHI). -
HIPAA Regulatory Alert: Know specifics of proposed rule
Unlike the current privacy rule which identifies purposes that might be omitted from disclosure accounting reports, the proposed rule published on May 31, 2011, identifies those purposes for which disclosures must be tracked and reported. -
HIPAA Regulatory Alert: Free tool assesses privacy risks
Frequent news stories and headlines about the Department of Health and Human Services (HHS) Office for Civil Rights' (OCR) crackdown on covered entities that have reported data breaches or other privacy rule violations increase the importance of continually assessing compliance with privacy and security rules.