Hospital Access Management – May 1, 2021
May 1, 2021
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Revenue Depends on Correct CPT Codes; Beware Sudden Changes
The revenue loss caused by CPT code changes is nothing short of staggering. When it comes to CPT codes that change after service, one of the biggest challenges is in the surgical space. Learn how some patient access departments are proactively addressing this problem.
If CPT Code Changes, Patient Access Can Obtain Payment
Patient access can intervene to stop an unauthorized test, assuming it is not emergent or urgent — or find out if the patient wants to go forward anyway. Registrars' expertise makes all the difference on whether the hospital is paid, and how quickly. Possibly, the health plan will agree a new authorization is unnecessary — as long as the clinical records are sent with the claim.
Real-Time Surveys Reveal True Feelings About Registration
The patient experience is a priority for hospitals, but typical patient satisfaction surveys are not much help to revenue cycle departments. Surveys usually do not reveal which registrar is responsible for the patient’s impression. Also, some respond to every other question in the survey, but leave the registration-related question blank for some reason. To better understand the patient experience, registrars hand out “Please tell my manager how I did” cards. The idea is to encourage patients to respond right after, or even during, their registration experience.
Patient Access Technology Evolving to Meet Customer Expectations
Artificial intelligence, machine learning, and predictive analytics all are available. Slowness to adopt these new tools stalls progress on a better registration experience.
Financial Counselors Find Unmet Needs at Vaccine Clinics
Everyone has to wait 15 minutes after receiving their COVID-19 vaccine. Financial counselors at Spectrum Health make good use of this time.
Copay Collection Cannot Delay Care, or Hospital Risks EMTALA Violation
Registrars should bring up payment or insurance only after a medical screening exam and stabilizing treatment has been provided. This means a patient should not be asked about copays or payment during the exam or while undergoing treatment.
Many Patients Worry About Hospital Bill During ED Visit
To prevent EMTALA problems, train staff well, giving them carefully drafted scripts to use for patients who insist on discussing insurance coverage before a medical screening exam.