Hospital Access Management – August 1, 2013
August 1, 2013
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Stop loss of Medicaid coverage — $362K obtained in one case
A transplant patient at Cook Childrens Medical Center in Fort Worth, TX, was eligible for coverage with the states Children with Special Health Care Needs program, but no reimbursement was possible as funding for the program had run out. -
Act now! Churn will continue
"Churn when otherwise-eligible Medicaid beneficiaries are disenrolled and re-enrolled in the program is a frequent problem and will continue to be so under the Affordable Care Act (ACA), according to Benjamin D. Sommers, MD, PhD, assistant professor of health policy and economics at Harvard School of Public Health in Boston. -
Some 'self-pays' already on Medicaid
Patient access staff at Trinity Regional Health System Rock Island, IL put the first and last name and social security number of every self-pay patient into a verification website to see if they have Medicaid coverage. -
Verification is 'huge' with Affordable Care Act
Like many patient access leaders, Linaka Kain, DE, a disability examiner and Medicaid specialist at Trinity Regional Health System Rock Island, IL, is expecting a large influx of newly eligible patients coming on to the Medicaid program as a result of the Affordable Care Act (ACA) in 2014. -
Duplicate reg? Fix it right away
Duplicate registrations decreased from 36 a month to seven, due to new processes at Childrens Hospital of Pittsburgh of UPMC. To decrease these errors, registrars should do the following: Be able to view the patient's address along with name, date of birth, and social security number. Pay close attention to details. Ask the right questions. -
Copay collections rose 30% — with help
Patient access employees at one facility were able to increase collections by 30% by having emergency department nurses walk patients to the discharge office so copays could be collected. Collections decreased when a supportive nurse manager left the organization. Collections increased again when nursing staff was educated on the importance of copays. It took time to establish a consistent increase in collections. -
Offer patients fast and accurate estimates
Less than 30% of patient access areas use patient liability estimator software, but this software is necessary to ensure patient satisfaction with growing numbers of underinsured and self-pay patients. Decide which tool will work best with your patient accounting or patient management system. Incorporate ability to pay functions and a presumptive charity care screen. Develop good financial policies for pre-registration and patient advocacy. -
Introduce access to clinical counterparts
Registrars have become much more comfortable calling clinicians with questions due to face-to-face meetings that take place at New York Presbyterian Hospital/Weill Cornell Medical Center in New York City. Bed assignment meetings begin with introductions. Registrars are seated next to triage nurses. Nurses obtain demographic information from patients presenting by ambulance. -
Stop long waits due to invalid orders
At times, patients face lengthy wait times due to missing or invalid orders in registration areas. These long waits decrease satisfaction scores for patient access. Educate provider offices on situations in which patients were inconvenienced. Have physicians use online scheduling, which requires ICD9 and diagnosis codes. Scan orders so they can be located online. -
Patients happier if they are 'connected'
Patient access leaders added mobile cell phone chargers to registration areas at Virginia Mason Medical Center after patients requested these chargers to decrease anxiety. Staff members don't have to field constant requests from patients for cell phone chargers. Patient access employees appreciate being able to use the chargers. Patient responses have been positive. -
What are the priorities for patient access?
In the 1990s, the focus was largely on the performance of the back end of the revenue cycle. This has largely paid off, and hospital leaders have turned to the front end for further improvements, according to Ronnie Dail, managing director of Huron Healthcare in Chicago. Dail says patient access requires an increasingly integrated approach for scheduling of appointments, sharing information with clinicians, and validating coverage. Here are three processes Dail says are top priorities for patient access -
Open-enrollment season will be the biggest on record
At the Silver State Health Insurance Exchange in Carson City, NV, workers have been counting down the days until Oct. 1 on an office corkboard, according to a report in Kaiser Health News.1 Now it is only days to the deadline for opening the online marketplaces that are a linchpin of the federal health law known as Obamacare, the report said.