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Incorporate the IM process and show compliance

Patient Access Weekly Advisor, January 16, 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 department managed to implement and demonstrate compliance with the new process without disrupting their successful routine.

Memorial Hospital is a 100-bed acute care facility. The patient population consists of 49% Medicare and 13% Medicare Advantage. In 2007, there were 6,869 patient discharges, with the average length of stay about 3.48 days.

In implementing the new practice, Stottlemeyer formed a task force composed of members from patient access, case management, 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. The following are a couple of the ways her department addressed the IM process:

Obtaining signatures. 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.

Education. Education about the process in the registration area is a challenge. Stottlemyer said that it is an ongoing process.

Certain education meetings during which they go over the form and hand out scripting for the staff members to use are mandatory.

"I am a firm believer in scripting," Stottlemyer said. "We use scripting extensively. It really takes the pressure off the staff and makes their jobs a little bit easier. It also delivers a consistent message to our patients." CM, nursing, and verification specialists also use the script.

The scripting language is taken right off the IM and is put into a concise format that highlights the most important aspects of the message and makes it easier to explain to the patient.

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