• E-mail
• Print
• RSS

Tip: Identify patient access trouble spots to decrease denials

Patient Financial Services Weekly Advisor, March 19, 2004

The admitting/access process often initiates problems that result in denied claims. By isolating potential hot spots, you can help educate your staff to reduce front-end data collection errors, says Cassandra S. Crowal, director of revenue enhancement and access services at MidState Medical Center, Meriden, CT.

She gives the following advice:

1. Conduct daily audits on your admission/registration process. Was an incorrect provider name the source? Was the wrong date entered?

2. Coordinate insurance company rejection feedback. It's important to keep track of why private payers are denying claims. Share your findings with your revenue cycle team.

3. Increase your training efforts. Provide job aids, quality assurance initiatives, and give continuous feedback. Conduct UB92 audits.

4. Look at your discharge process. A lot of money is lost for not filing information in a timely manner. Do you monitor your late charges? Audit and report on missing authorizations and share findings with staff.

5. Analyze billing strategies. Some hospitals take a function of patient financial services, such as accounting, and move it to patient access. Spearhead a rejection activity report, and a zero payment report.

6. Monitor reimbursement activities. Get feedback regarding underpayments from your PPOs and HMOs. Use LMRPs as appropriate and be sure to use tracking and trending reports.

• E-mail to a Colleague
• Print
• RSS
• Archive