Revenue Cycle

Delivering the Advanced Directive form

Patient Access Weekly Advisor, December 31, 2008

Advance Directive forms, to be completed by patients in case they are unable to make medical decisions for themselves, most often are presented by patient access staff members.

But any lack of communication among access, nursing, and case management staff members can lead to unnecessary confusion and headaches during compliance checks. Mandatory requirements from CMS, including the Fair Patient Billing Act, are on the minds of access managers lately. The goal is to comply and present Advance Directive forms in the most patient-friendly, transparent way.

Here are two tips from one patient access manager:

Just ask. The responsibility lies with patient access staff members to ask whether patients have or need a form. "My staff are informed during training on how to ask," says Vonda DeLorenzo, patient registration supervisor at Central Michigan Community Hospital in Mt. Pleasant. "For example: 'I see that you don't have an Advanced Directive for Healthcare. Would you like a copy?' "

Explain it like a “living will.” What if a patient asks about the form? DeLorenzo says they explain it as if it were a "living will," although Michigan doesn't recognize that term. "It is where you set up in advance your medical wishes should you become incapacitated and are unable to speak for yourself regarding your medical care," DeLorenzo adds. "You usually appoint an advocate who will act on your behalf, and [he or she has] to agree to act on your behalf. We try to keep it short and sweet and not spend too much time on it. Very few people are interested. You always get the one who wants to know if they are going to die today."

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