Hospital Access Management – April 1, 2014
April 1, 2014
View Issues
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Hospital cuts denials by 63% despite a surge in payers
Patient access areas are seeing more procedures requiring authorization, a surge in the number of insured patients, and more clinical requirements from payers. All of these factors make an increase in claims denials - and much lost reimbursement - very likely. -
Clinical information coming into play
Payers are looking at medical necessity -
Establish rapport with payer reps
Patient access managers must stay in contact with their assigned provider representatives and establish a good working relationship with these individuals. -
How you can address price-shopping patients
Patient access departments are offering financial counseling and online price estimates to patients who call with questions about cost. -
Patients create their own estimates
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Extra steps needed for 'exchange' plans
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E-learning: 4,800 hours of coverage costs saved
By developing e-learning modules, patient access areas at Hennepin County Medical Center in Minneapolis save an estimated $96,000 annually on coverage costs. -
Two extra hours to 'shadow' staff
Trainers reallocated from classroom -
Successful `first run' at e-learning
Modules will be tweaked, updated -
CMS' two-midnight rule: Who must sign off?
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`Balance billing' leaves patients shocked
In emergent situations, paperwork is often the last thing on a patient's mind. -
NAHAM to hold annual conference