Revenue Cycle

Four days and off you go: Day 2

Patient Access Weekly Advisor, March 24, 2010

Editor’s note: The following is the second of a four-week look into the training program for registrars at Boca Raton (FL) Community Hospital. The patient access department at Boca Raton breaks down the four-day training program into categories and subcategories and sets goals regarding how long each training module should take.

Day two. The second day of training begins with a four-hour introduction to Medicare. Staff members learn what certain cards look like and get a crash course on Medicare Parts A and B, advance beneficiary notices (ABN), and medical necessity, among other areas.

“[Our new hires are] off the streets working at public supermarkets,” says Michele Vail, manager, patient access. “If you don’t teach them this, it’s going to make their heads fall off when they have to do it.”

The introduction also includes:

  • Rules and regulations
  • Medical compliance
  • Medicare Secondary Payer
  • Retirement dates
  • Occurrence codes

After covering Medicare, Boca Raton takes five hours to introduce staff members to Real-Time Eligibility (RTE) Relay Health, which is Boca Raton’s eligibility software.

The introduction includes:

  • How to view responses
  • Correct identification of Medicare replacers
  • Working aged when Medicare is secondary
  • How to match plan codes with RTE messages
  • Effective troubleshooting when an RTE error message appears
  • Correct identification of Medicare replacers and liability insurance coverage
  • Applying facility benefits to specific tests

In the last 120 minutes of the day, staff members receive an introduction to liability and workers’ compensation.

Topics covered include:

  • The required essential data elements
  • Basics in PIP insurance
  • Understanding liability coverage amount

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