Hospital Access Management – October 1, 2012
October 1, 2012
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Getting aggressive with collection of ED copays? Don’t violate EMTALA
You might assume that registrars giving emergency department (ED) patients the impression that they are required to pay money to receive treatment is a thing of the distant past, as this situation is a likely violation of the Emergency Medical Treatment and Labor Act (EMTALA) which has been in place since 1986. -
Revenue captured increases $1.5 million
Annual revenue collected for Medicaid patients has doubled at Trinity Regional Health System in Rock Island, IL, since January 2010, since the screening process is now done internally instead of by a contracted company. -
Which patients are Medicaid-eligible?
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. -
Identify internally, and outsource follow-up
At Harris Health System in Houston, patient access staff identify patients who fall into the category of self-pay or under insured, but the completion of the application and follow-up is outsourced, reports Veronica Rodriguez Patricio, audit, appeals, quality assurance, and training manager for eligibility and registration services. -
ED ‘checkout’ adds $1 million in revenue
A third of patients seen at one Arizona emergency department (ED) were uninsured, but this percentage was cut in half after a checkout process was implemented, reports Todd B. Taylor, MD, FACEP, a Phoenix, AZ-based consultant specializing in Emergency Medical Treatment and Labor Act (EMTALA) compliance. -
ED revenue doubles with new process
Emergency department (ED) collections jumped from $55,000 to $120,000 annually after eligibility software was implemented at Mary Rutan Hospital in Bellefontaine, OH, reports John E. Kivimaki, director of patient accounts. -
Make it a top priority: single service changes
For one month, patient access leaders at Witham Health Services in Lebanon, IN, targeted one simple but important change to improve the level of customer service given by registrars. -
Payers might give you the wrong information
Recently, a large payer denied a claim for a CT scan of the abdomen due to no authorization, even though a registrar previously had been told none was required. -
Stop denials due to inaccurate info
When speaking with a payer representative, verify eligibility first, then move on to more specific details such as service category and codes, recommends John T. Porter Jr., access denial analyst for patient financial services at Scripps Health in San Diego. -
Document this when speaking with payer
The fact that payers almost never give a guarantee of payment prior to service and require registrars to confirm that there is no guarantee should set off warning bells when verifying coverage information, says John T. Porter Jr., access denial analyst for patient financial services at Scripps Health in San Diego, CA. -
Asked about costs? Give first-rate service
While many patient access departments can give patients the estimated full cost of a service, to date, very few are able to provide an accurate out-of-pocket estimate, says Becky Peters, regional director of patient access services for Sutter Health West Bay in San Francisco. -
Be very clear: It’s just an estimate
When patients call and ask what a test costs, the information isnt always straightforward, says Robin Woodward, CHAM, patient access director at Riverside Regional Medical Center in Newport News, VA. -
Survey: Hospitals name least favorite insurers
It is a truth universally acknowledged that health insurance companies can be a pain for patients. What may be a surprise is that hospitals often complain, too, for the same reasons: denied claims, low reimbursement, late reimbursement, and thickets of red tape. -
State Medicaid expansions show several benefits
In a study recently published in The New England Journal of Medicine,1 state Medicaid expansions to cover low-income adults were significantly associated with several benefits, including reduced mortality and improved coverage, access to care, and health, as self-reported.