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Incorporating the Important Message from Medicare (IM)

Patient Access Weekly Advisor, January 9, 2008

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In the HCPro audioconference, "The Important Message from Medicare Regulation: Typify your process and ensure compliance," Christine Stottlemyer, CPAM, patient accounting director at Memorial Hospital in York, PA, discussed how her group managed to implement and demonstrate compliance with the new process without disrupting their successful routine.

Stottlemyer formed a task force composed of members from patient access, CM, patient financial services, and quality review and began reviewing the current process to determine how to best incorporate the new procedure into the hospital's admission process.

When a patient is unable to sign, or a designee is not present during the admission process, the message is placed on the patient's chart, and nursing then assumes responsibility. This system has worked well for Memorial; however, registration will send the admitting clerk to the floor to make sure the signature is obtained within two calendar days. Charts are reviewed within 24 hours and checked for that initial signature as part of the normal review process.

At Memorial, all inpatients go through a verification department. If the verification specialists uncover Medicare or Medicare Advantage coverage, they will go to the floor to review the Medicare questionnaire and the IM with the patients using the prepared script. They will obtain signatures, give the patients their copies, and deliver the original and copy to the nursing department for placement on the patients' charts.

Stottlemyer said that it is always a team effort. "This is really everyone's responsibility," she said. "It's not just access, it's not just care management-it's nursing, it's physicians, it's everyone."

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