Access manager pens compliance encyclopedia’
It’s everything access has to deal with’
When administrators at Mt. Graham Community Hospital in Safford, AZ, decided to develop a kind of "model compliance encyclopedia" for the entire facility, admissions manager Julie Johnson got the directive to put together the volume for her department.
Many hours of work later, the result, Johnson says, is a manual devoted to "everything access has to deal with" in terms of compliance and the federal government. "It tells us what a corporate compliance officer or the Office of the Inspector General [OIG] would be looking for," she says. "There is policy and procedure on all of it."
The manual is unique, Johnson notes, because it takes information that affects access services from a variety of sources and makes it easily accessible. Among other issues, the manual addresses:
• Medicare issues, including eligibility, the advance beneficiary notice, the Medicare Secondary Payer process, and the three-day rule;
• what it takes to process a clean claim;
• insurance verification;
• why hospitals should have compliance programs;
• patient rights and requirements;
• employee requirements, including continuing education;
• charity care concerns;
• a training checklist.
Johnson has received telephone calls from access managers around the country asking for more information on the manual, she says. "There is nothing out there like it, and they’re trying to develop their own. It took me six weeks to do it, staying up nights and working on weekends. It was like trying to come up with something out of the air."
She drew on a number of resources to prepare the manual, including these:
• Journal of the American Hospital Information Management Association 69(1);
• Hospital Access Management;
• The annual National Association for Healthcare Access Management conference;
• Arizona Hospital and Healthcare Association (AzHA) compliance guide;
• AzHA Electronic Conference: "Investigation and Monitoring Systems for Health System Reimbursement"
• OIG compliance training seminar;
• the Web sites www.acutecare.com/emtabul. htm and www.medlaw.com/handout.htm.
[For additional information on Johnson’s compliance manual, contact her at Mt. Graham Community Hospital, 1600 S. 20th Ave., Safford, AZ 85546. Telephone: (520) 348-4000. Fax: (520) 348-4028.]
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