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Auditing the registration process: Part three

Healthcare Auditing Weekly, June 14, 2005

Last week, we discussed the second three steps you should take to ensure that the registration staff in your organization captures the information needed to obtain accurate reimbursement. This week, we'll take a look at three more. After drawing a sample, observing the registration process, and reviewing copayments, follow these steps:

1. Verify insurance

• Ask staff members who are responsible for verifying insurance information about the accuracy of the information they receive from the registration staff
• Review files to determine whether staff verified insurance information for the previous day

2. Gather documentation

• Review the various forms that the registration department uses
• Review the patient account notes
• Identify reasons for denial
• Review monitoring data
• Review billing documentation
• Review copies of insurance cards

3. Review inpatient registration

• Obtain a copy of the schedule and review its reconciliation
• Obtain a copy of all the encounter forms to compare with the schedule
• Review that patient's insurance type
• For Medicare patients, verify that the patient completed the Medicare Secondary Payer (MSP) questionnaire
• Verify that the patient received that privacy notice
• For established patients, pull the medical record and determine whether insurance from the prior visit was the same.

Look for next week's issue when we go over the final steps for auditing the registration process.

The above tip is an excerpt from the book "Hospital Auditing and Monitoring: Sample Programs for Key Risk Areas," copyright 2005 by HCPro, Inc. This book is a step-by-step, practical manual that offers sample audit programs for the most troublesome areas that a hospital must audit. The binder and CD-ROM are filled with actual audit programs used by auditors and compliance officers in the field. Click here for more information or to order your copy today.

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