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While many patient access departments can give patients the estimated full cost of a service, to date, very few are able to provide an accurate out-of-pocket estimate, says Becky Peters, regional director of patient access services for Sutter Health West Bay in San Francisco.
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It is a truth universally acknowledged that health insurance companies can be a pain for patients. What may be a surprise is that hospitals often complain, too, for the same reasons: denied claims, low reimbursement, late reimbursement, and thickets of red tape.
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Annual revenue collected for Medicaid patients has doubled at Trinity Regional Health System in Rock Island, IL, since January 2010, since the screening process is now done internally instead of by a contracted company.
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You might assume that registrars giving emergency department (ED) patients the impression that they are required to pay money to receive treatment is a thing of the distant past, as this situation is a likely violation of the Emergency Medical Treatment and Labor Act (EMTALA) which has been in place since 1986.
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Identifying Medicaid-eligible patients is a top priority for patient access staff at The University of Tennessee Medical Center in Knoxville, reports Stephen Hovan, vice president of the revenue cycle.
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In a study recently published in The New England Journal of Medicine,1 state Medicaid expansions to cover low-income adults were significantly associated with several benefits, including reduced mortality and improved coverage, access to care, and health, as self-reported.
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When patients call and ask what a test costs, the information isnt always straightforward, says Robin Woodward, CHAM, patient access director at Riverside Regional Medical Center in Newport News, VA.
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A third of patients seen at one Arizona emergency department (ED) were uninsured, but this percentage was cut in half after a checkout process was implemented, reports Todd B. Taylor, MD, FACEP, a Phoenix, AZ-based consultant specializing in Emergency Medical Treatment and Labor Act (EMTALA) compliance.
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When speaking with a payer representative, verify eligibility first, then move on to more specific details such as service category and codes, recommends John T. Porter Jr., access denial analyst for patient financial services at Scripps Health in San Diego.
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The fact that payers almost never give a guarantee of payment prior to service and require registrars to confirm that there is no guarantee should set off warning bells when verifying coverage information, says John T. Porter Jr., access denial analyst for patient financial services at Scripps Health in San Diego, CA.
