Skip to main content

Risk & Quality Management

RSS  

Articles

  • Patient’s coverage inactive? Say this

    A patient recently registered at Denver-based Porter Adventist Hospital had just lost his job and employer-sponsored insurance, and he was under the mistaken impression that COBRA coverage was automatic.
  • Top performer to train ED registrars

    Since copayments first were collected in Cambridge (MA) Health Alliance’s three emergency departments (EDs) in October 2008, collections have increased 140%, totaling $173,000 in fiscal year 2009 to an expected $416,000 in fiscal year 2012.
  • Some access info not good for e-learning

    When patient access leaders had to select a subject for the first e-learning module developed at St. Luke’s University Health Network in Allentown, PA, they chose computer downtime procedures
  • Struggling collectors may need to try harder

    While a small group of registrars at Legacy Health in Portland, OR, were effective collectors, and most were trying their hardest, about one-third weren’t making much of an effort to collect anything at all.
  • Cover training needs by adding e-learning

    Previously, it took some patient access employees over an hour to travel up to 40 miles to a training site for required education at St. Luke’s University Health Network in Allentown, PA. Now, employees can take some of the training right from home or at their current facility.
  • Multiple authorizations for single procedures

    We are now receiving denials for failing to obtain authorization for the medication in those injections. This is something we had not seen previously,” reports Jeanette Foulk, director of patient access at Methodist Charlton Medical Center in Dallas.
  • Wrong primary payer? Bad info equals denials

    Registrars might learn more information after asking patients with inactive coverage, “While reviewing your insurance, we are getting notification that you have another primary payer. Do you have any other insurance?
  • MSP accuracy must be at 98%

    Patients might tell a registrar that they still have a Medicare Advantage plan when they no longer do, that they do not have supplement A & B coverage when they actually do, or that they have Medicare for disability coverage when it is really for end stage renal disease.
  • Revamp process for admission notification

    If a patient is admitted on a holiday or after normal business hours and registrars are unable to notify the payer until the next business day, the claim could be denied for late notification, warns Jeanette Foulk, director of patient access at Methodist Charlton Medical Center in Dallas.
  • Bring service up to a higher level

    When Cynthia Norman-Bey, director of patient access services and the PBX (private branch exchange) Call Center at Glendale Adventist Medical Center, notices an employee’s customer service skills are lacking, she pairs him or her with a high performer.