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Benefits exhausted, coverage not in effect at the time of service, patient ineligible at the time of service, no authorization prior to service, and patient unidentified. Each of these reasons for a denied claim is different, but the result is the same - the hospital doesn't collect. And in today's economy, this spells trouble for patient access departments.
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Too often, patient access is an area employees come into only to get their foot in the door with a long-term goal of obtaining other medical positions in the hospital, says Vicki Lyons, patient access manager at Baptist Hospital East in Louisville, KY.
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Because of rising copays and deductibles and underinsurance, patients are getting hit with bigger balances that they don't expect. More and more, patients want to know up front what they will owe.
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The shift from handling verification, eligibility, and collection issues on the front end - before or during registration - is continuing, and this is good news for patient access.
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Over the past decade, several large-scale disasters have tested emergency response teams and healthcare providers. They've also tested the research community's ability to quickly, efficiently and ethically dispatch investigators to do vital research that could help prevent and respond to future disasters.
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Haverford College of Haverford, PA, has spent more than a year dealing with a problem that IRBs do everything they can to avoid: a research noncompliance investigation requested by the Office for Human Research Protections (OHRP).
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Honest broker systems which process data and specimens for research by removing identifiers that otherwise would compromise patient privacy have been touted as a smart way to encourage research while still protecting patient privacy as required by the Health Insurance Portability and Accountability Act (HIPAA).
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One strategy that helped a Lexington, KY, university research institution achieve full accreditation was its development of IRB approval checklists.
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A series of two-day regional conferences will be held next year focusing on Food and Drug Administration clinical trails requirements, regulations and compliance issues.
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IRB professionals responding to IRB Advisor's 2008 Salary Survey continue to report modest salary increases and larger staffs over the previous year. But they worry that raises aren't keeping up with increasing workloads and that they and their staffs are burning out.
