Hospital gets a grip on MSPQ process
When a Medicare audit in the summer of 1999 found problems with the way Sarasota (FL) Memorial Hospital was handling the Medicare Secondary Payer Questionnaire (MSPQ), the hospital took immediate action, reports Susan Evans, CPAT, skills development manager for the patient registration department.
At one point, the hospital had more than $1 million a day in unbilled accounts, waiting for a completed MSPQ before they could be sent to Medicare, Evans says. As of February 2000, that figure had dropped dramatically and is now at about $50,000 per day, she adds, with an ultimate goal of zero.
No. 1 in the hospital’s action plan, Evans says, was "a lot of education and repetitive training for registration staff." As departmental trainer — a job that had not been filled in recent years — she gives employees constant feedback on all registration errors, including problems with the MSPQ, she says. "When errors are made, we give the whole unbillable piece back to the people who made the mistakes. They have to call the patient at home [to get the missing information]."
In the past, Evans notes, the mistakes were handled at the back end by patient financial services.
Another key to the MSPQ improvement has been a dual software solution, she says. At the time of the Medicare audit, registrars were handling the MSPQ manually, she explains. "Before that, we had an automated system, but it gave the admitting representative the option of passing, and the data was questionable."
Now, with help from the information systems department, the hospital’s homegrown admission/discharge/transfer system has been modified so an account can’t be billed without an MSPQ, she says. A system called CareMedic completely screens every Medicare claim, looking for accident details that might indicate another payer is primary, Evans says.
Sarasota Memorial now has an annual training session for anyone who registers patients, as well as for all new employees, she says. Incomplete or incorrect accounts continue to go back to the person responsible on a daily basis. "It was very hard at first, but it worked," Evans adds. "What came out of it is that there are not as many errors. Before ending an account, [the registrar] thinks, Am I going to get this back tomorrow?’"
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