Hospital Access Management – October 1, 2015
October 1, 2015
View Issues
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Payers Want Detailed Clinical Info for Authorizations
You need to know why a procedure is necessary ... right?
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More payers asking for peer-to-peers
Patient access needs excellent processes to respond to payer requirements for peer-to-peer review of the patient’s medical records, says Ketan Patel, a senior manager in the healthcare provider segment of strategy and operations for New York City-based Deloitte Consulting
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Different CPT done than was authorized? Payers refuse to pay the claim
Some claims denials stem from incorrect CPT codes given by providers.
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Foolproof ways to move up quickly in access
Suggestions from experts
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Novel ways you can network
Put your best foot forward with these tips
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Emails are too slow — Here are new ways to communicate with patient access staff
Is an irate patient demanding to speak with a supervisor? Does a registrar need to leave immediately because of a family emergency?
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Four hours a day is too much time on the phone with payers — Hold times last up to 45 minutes
Financial counselors at Stonybrook University Medical Center spend about four hours a day on the phone with insurance companies verifying inpatient benefits and obtaining authorizations.
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Satisfy patients — Don’t disparage clinical areas
At Eisenhower Medical Center in Rancho Mirage, CA, patients often call the front desk because their prescriptions have not been called in, because they’re unable to get in to see their primary care physicians, or because they’ve waited days for a call back from a clinical area.
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Put patient access staff members in clinical areas
Patient access staff members should shadow employees in the clinical departments they schedule for.
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Automated calls cut no-show rates to 0%
Patient access/registration/scheduling areas are using automated reminder calls to reduce no-shows. No-shows in behavioral health were cut by 20% at Western Connecticut Health Network. Some practices at Orlando Health now have 0% no-show rates.
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Hospitals join hotels in receiving reviews on Yelp
The newest addition on the Yelp web site is reviews of hospitals, nursing homes, and doctors.
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HHS issues county data on Marketplace plan selections
The Department of Health and Human Services has issued county-level data on 2015 open enrollment in qualified health plans in the states that use the HealthCare.gov platform for their Health Insurance Marketplace.