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Hospital Access Management – October 1, 2011

October 1, 2011

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  • With revamped processes, collect millions in retroactive payments

    Would you consider one-year-old uncollected account with a large outstanding balance to be a lost cause that ultimately will need to be written off?
  • Half of self-pay patients found Medicaid-eligible

    About half of the self-pay patients presenting for services at Vanderbilt University Hospital in Nashville ultimately obtain Medicaid coverage, reports Marsha Kedigh, RN, MSM, director of admitting/emergency department registration/discharge station/insurance management.
  • Designate 'go to' person for registrars, clinicians

    In a quick-moving, high-volume area such as the emergency department (ED) of Botsford Hospital in Farmington Hills, MI, communication breakdowns are bound to happen between patient access and clinical staff.
  • Denials on the rise for radiology claims

    Payers are asking for more authorizations for high-dollar radiology procedures, and claims denials are resulting, reports Stephen Hovan, executive director of patient fiscal services at The University of Tennessee Medical Center in Knoxville, who adds that his department is seeing a 75% increase in authorizations for radiology processes.
  • Department gets ahead of 'mismatch' denials

    Almost all private plans now require authorizations for radiology services, reports Richard J. Suszek, director of patient access at Barnes-Jewish Hospital in St. Louis, MO, and Missouri Medicaid began requiring authorizations in July 2010.
  • Regain lost revenue due to claim of no auth

    Claims denials at The University of Tennessee Medical Center in Knoxville have increased 20% to 30%, particularly from major payers including The Blue Cross and Blue Shield Association, United Healthcare, and Humana, according to Stephen Hovan, executive director of patient fiscal services.
  • Is your patient dealing with high out-of-pocket?

    More often, patient access financial counselors find themselves in the unenviable position of telling patients about out-of-pocket responsibilities running into the thousands of dollars.
  • ED collections surge when asking for copays

    Just a couple of years ago, registrars in the emergency department (ED) at the University of Connecticut Health Center in Farmington collected only $100 to $1,000 a month in copays.
  • Referring physicians may misunderstand

    The Access Center is the first contact that a referring physician has with the hospital, notes Bob Potter, RN, manager of access and preadmissions at University of Colorado Hospital in Aurora. "The first impression is the lasting impression," he says. "Customer service is our sole reason for existing."
  • Ask 'star' registrars: Educate struggling staff

    A team of patient access specialists consisting of top performers, role models within the division, and lead personnel offer a wide range of expertise and experience to registrars at Carolinas HealthCare System in Charlotte, NC, reports Christina Baugh, supervisor of PRN registrars and Patient Financial Service Specialists for corporate patient access.
  • 'Tricks of the trade' should be shared

    Registrars at Carolinas HealthCare System in Charlotte, NC, benefit from "tricks of the trade" shared by specialists within the department, reports Christina Baugh, supervisor of PRN registrars and patient financial service specialists for corporate patient access.
  • Hear a complaint? Don't jump to conclusions

    If a patient complains that a registrar seemed to care only about money, or insists he or she waited way too long to be registered, Jan Fowler, director of patient accounting at Saint Vincent Health Center in Erie, PA, makes a point of meeting with the staff person involved to hear their side of it.