Which patients are Medicaid-eligible?
Screen self-pays internally
Identifying Medicaid-eligible patients is a top priority for patient access staff at The University of Tennessee Medical Center in Knoxville, reports Stephen Hovan, vice president of the revenue cycle.
“We have worked with vendors that specialize in eligibility to ensure we are capturing all the patients that may be eligible for safety net programs,” Hovan says. “We have also increased our financial counseling roles internally.”
In FY 2011, staff collected on 69% of the accounts identified as Medicaid-eligible, totaling 1,594 accounts and $73 million, but this amount is expected to increase to $82 million in 2012, reports Hovan.
Questions to screen for eligibility for public programs were embedded into the system so that financial counselors don’t have to remember them, he explains.
The same process is going to be used to comply with new regulations for nonprofit hospitals regarding how patients need to be notified about charity care programs, says Hovan. “There will be very strict timeframes for when and how to notify them,” he says. “From our standpoint, the increases in the safety net programs are going to drive how the charity applications are done.”
If patients don’t have coverage, financial counselors do whatever they can to obtain them coverage of some sort, which will put the department in a good position to help newly eligible patients in 2014, says Hovan.
Several FTEs in the business office have been reallocated to the front end to handle the additional financial counseling. “What we are trying not to do is add additional resources,” says Hovan. “We are trying to reallocate and work with the resources that we have.”
Access is issue
Jennifer Cameron, MBA, director of patient access at Children’s National Medical Center in Washington, DC, says, “It is important to communicate the services that we provide upfront, to increase awareness and improve access.”
Many patients and families are reluctant to seek care because of their inability to pay, she adds. “We have noticed an increase in our uninsured and underinsured patient population,” says Cameron. “Early identification is a primary focus within the patient access department.”
Patient access leaders have received positive feedback from families, who say it decreases the amount of stress involved, says Cameron. She gives these recommendations:
• Provide literature in different languages to address the needs of your diverse patient population.
• Identify uninsured and underinsured patients early in the process.
• Utilize resources, such as onsite representatives of the Department of Health and Human Services, to aid with face-to-face interviews and timely processing of applications.
• Have an “open house” to screen people in the community for Medicaid eligibility.
Identifying Medicaid-eligible patients is a top priority for patient access staff at The University of Tennessee Medical Center in Knoxville, reports Stephen Hovan, vice president of the revenue cycle.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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