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Understand the rules to collect full reimbursement and remain compliant

Patient Access Weekly Advisor, May 28, 2008

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The Medicare inpatient notification process, including notices related to limitation on liability and the respective notice forms, has been revised significantly during the past year.

As a patient access manager, you’re responsible for making sure your team remains compliant with the rules to ensure accurate reimbursement for noncovered services. Your team is the front line in implementing the new forms, known as Hospital-Issued Notices of Noncoverage (HINN).

You can help the process by:

• Ensuring that your staff members work with other departments, such as case management, as well as the patient’s physician
• Integrating new policies with old ones
• Documenting all new material
• Educating staff members on the changes
• Consistently auditing and monitoring the process

The main challenge is to incorporate the revised procedures into related hospital operations (e.g., registration, care management, the discharge process). It is particularly important to plan for weekend and holiday implementation.

Provided by Judith L. Kares, JD, CPC

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