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Gaining patient consent and provider adoption for health information exchanges (HIEs) is important for the success of the effort, and patients must be adequately educated about the HIE or they may not give their permission, says Jared Rhoads, senior research analyst with CSC, a technology consulting company based in Falls Church, VA.
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A pregnant woman at full term presented to the hospital for the birth of her son. The baby was delivered via Caesarean section. Normal tests were conducted on the newborn, and all seemed to be in order.
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A 57-year-old nursing home resident with a history of dementia climbed out the open window in her room, falling 30feet to the ground below. The woman suffered severe injury as a result of the fall, and a jury awarded the plaintiff $276,164 in damages.
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Uncollectible funds, or "bad debt," is a problem your patient access department can't afford to ignore. With increasing numbers of self-pay, uninsured, and underinsured patients access managers should revamp processes sooner rather than later.
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Are you certain the patient's insurance is actually active? The earlier in the process you learn this information, the more likely you are to avoid bad debt.
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If a patient becomes upset about the amount he or she will owe, Joseph Ianelli, senior financial manager of Boston-based Massachusetts General Hospital's admitting department, says that the message patient access staff want to give is: "There is something we can do for you. We want you to get the medical care you need."
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Without question, the mistakes made by front-end staff can make or break the success of your patient access department. "Registration is one of the important components of patient care," says Debra A. Artwell, manager of outpatient access at Pennsylvania Hospital, part of the University of Pennsylvania Health System. "The patient demographics and financial information are data that follow the patient throughout our entire health system."
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It sounds fairly cut and dried: If an authorization isn't obtained from a payer, the claim will be denied. However, payer requirements are getting more and more complex and stringent.
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Over the past several years, patients repeatedly told registrars at Bay Care Health System a Tampa, FL-based system consisting of 11 not-for-profit hospitals, outpatient facilities, and services that they were concerned about medical identity theft. They didn't want to provide sensitive identifying information, such as Social Security number, each time they accessed the facility.
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Patient access staff at Tallahassee (FL) Memorial Hospital are about midway through implementing new software, which Joan S. Braveman, director of patient access and financial services, says "will really take us to the new level."
