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Risk & Quality Management

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  • Treat challenging patients with understanding, respect

    Every case manager encounters challenging patients and family members those who are angry, provocative, depressed, or just plain ornery. That's because people in the hospital are sick, under stress, and often fearful about their situation.
  • Redesign standardizes care coordination

    A far-reaching redesign of the care coordination process at Norfolk, VA-based Sentara Healthcare has standardized the process across hospitals, centralized the administrative and clerical tasks that care coordinators must perform, and freed the staff at the bedside to concentrate on working with patients.
  • Don’t wait to revamp insurance verification

    Healthcare reform makes processes for insurance verification a top priority for patient access areas, says Sebrena Johnson, manager of insurance verification and precertification in the Admission Services Department at Cone Health System in Greensboro, NC.
  • Do you tell patients about charity care?

    Your patient access department already might have a discount policy in place, but this policy doesnt do anything to help a patient unless he or she is aware of it.
  • You must get ready now for many more eligibles

    Patient access departments need to prepare for a great increase in the volume of patients who are eligible not only for Medicaid, but also private insurance policies, as a result of the Patient Protection and Affordable Care Act (PPACA) according to Luis Guerrero, director of patient access services at Ochsner Baptist Medical Center in New Orleans.
  • Self-pay A/R cut by $15 million

    Self-pay accounts receivable (A/R) was reduced by about $15 million annually after the patient access department at Geisinger Health System in Danville, PA, implemented daily eligibility checking of self-pay accounts against Medicare and Medicaid to find instances in which patients had coverage for that particular date of service.
  • Patient may not be ‘true’ self-pay

    Patient access staff at Methodist Charlton Medical Center in Dallas now run all self-pay patients through an automated verification system to identify those that are unaware that they are still active with the Medicaid program.
  • What’s even more critical for access? Service

    There is a growing emphasis on sensitivity in hospital collections that patient access staff should be aware of, advises Richard L. Gundling, FHFMA, CMA, vice president of healthcare financial practices for the Healthcare Financial Management Association (HFMA).
  • Does applicant have service skills, or not?

    Jamie Kennedy, a patient access supervisor at Ohio State University East Hospitals ambulatory clinic, says that her clinic is hiring additional staff, and customer service is her number one priority.
  • Offer price estimates for ‘self-service’

    Patients are asking patient access staff for various self-service options for registration processes, including price estimates, reports Angela Long, associate vice president of administrative services in revenue management at Geisinger Health System in Danville, PA.