Save 30 minutes by notifying online
At times, registrars are stuck on the phone for 30 minutes before even speaking to a representative, when notifying a payer of a patient's admission, says Amy Lloyd, patient access coordinator at Trinity Muscatine (IA).
Being able to submit notifications to payers electronically is "a huge timesaver," says Lloyd. "The traditional call to the insurance company could take a while, especially during peak hours."
Staff can notify payers at any time of day, even during after-hours or weekends/holidays if needed, she adds.
Electronic notification has dramatically cut the amount of time staff spend being placed on hold with payers, says Natalie Uy, RN, BSN, CCM, manager of patient access and emergency department registration at WakeMed Health and Hospitals in Raleigh, NC. "Because we are no longer spending time on hold or being transferred from one department to another, we were able to handle an increase in patients without a substantial increase in staff," she reports.
Denials still possible
While online notification means less time on the phone with payers, staff still need to follow up to be sure there were no system errors, advises Sandra N. Rivera, RN, BSN, CHAM, director of patient access at St. Joseph's Regional Medical Center and St. Joseph's Wayne Hospital, both in Paterson, NJ.
"Payers need to get on board to develop a standard way of doing this that is efficient," Rivera adds. "Currently, we do something different for every payer, including using different software."
Data errors could cause a delay in notification that could result in a claims denial, she says. For one payer, staff members manually enter the data and later view the authorization, which then has to be transcribed into the billing system.
Staff members scan the screen print of the authorization into the patient's account, so the billing staff can easily access it if necessary, says Lloyd. At least half of the department's notifications are now done online, she says, which takes about 5 minutes, depending on whether the data elements needed are available to the access staff at the time of entry. For example, payers might require clinical documentation to be attached.
"Some sites require diagnosis codes, which our access staff do not have available. Those are left for the next business day," says Lloyd.
Electronic notifications are frequently time-stamped as to the time the notification to the payer was completed, says Uy, which gives proof of the exact date and time it was done. "When claims are unjustly denied or reimbursement penalties are applied, we are able to appeal these," she says. (See related story, below, on the department's process for obtaining authorizations.)
Sources
For more information about electronic notification of admissions, contact:
Amy Lloyd, Patient Access Coordinator, Trinity Muscatine (IA). Phone: (563) 264-9460. Fax: (563) 264-9408. Email: [email protected].
Sandra N. Rivera, RN, BSN, CHAM, Director, Patient Access, St. Joseph's Wayne Hospital and St. Joseph's Regional Medical Center, Paterson, NJ. Phone: (973) 754-2206. Fax: (973) 754-4662. E-mail: [email protected].
Natalie Uy, RN, BSN, CCM, Manager, Patient Access/Emergency Department Registration, WakeMed Health and Hospitals, Raleigh, NC. Phone: (919) 350-8561. Fax: (919) 350-0690. Email: [email protected].
At times, registrars are stuck on the phone for 30 minutes before even speaking to a representative, when notifying a payer of a patient's admission, says Amy Lloyd, patient access coordinator at Trinity Muscatine (IA).You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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