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Patient Access Weekly Advisor

PAWA offers best-practice tips from access professionals across the country who have found success with innovative approaches to problems. PAWA will also include a timely news brief to help you fine-tune processes and develop solutions for ongoing problems, such as collecting more money upfront and determining deductibles on high-deductible health plans.

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Patient Access Weekly Advisor

Issue 31, December 26, 2007

• Report outlines plan for expanded healthcare at reduced cost

  A report released last week proposes a plan to save Americans $1.5 trillion in healthcare costs...

• Nonemergency surgical prepayments

  Although asking your registrars to request money up front from patients is not a new concept, it is...

• Automated patient financing

  Customer service is now a major concern for all providers. With so many options for customers...

Issue 30, December 19, 2007

• New credit score system to debut this summer

  Members of the healthcare industry are creating a new kind of credit score to judge patients...

• Provide patients with financial options

  Many providers focus too much on the size of the outstanding bill. They aggressively pursue the...

• Offer a career ladder for patient access

  When Linda Southard, the regional manager of patient registration for Asante Health System (AHS) in...

Issue 29, December 12, 2007

• UnitedHealth billing flaws persisted as company grew

  UnitedHealth has been sanctioned in nine states in the past seven years for paying claims...

• Keep staff happy with a successful flexible hours program

  Some access departments use a flex-hours system that allows a staff member to schedule his or her...

• Conduct initial competency exams

  The interview process has several critical components that allow departments to have the best...

Issue 28, December 5, 2007

• Congress to submit children's healthcare bill

  Democratic leaders in Congress said last week they would send the children's healthcare expansion...

• Determine realistic patient throughput solutions

  Poor patient throughput is common in hospitals nationwide. EDs are overcrowded, beds are scarce...

• Inform your patients of payment options up front

  Many patients do not understand how financial assistance works, and when and if they should...

• Quick Medicare compliance survey

  Quick Medicare compliance survey

Issue 27, November 28, 2007

• Illegal immigrants' emergency room visits fewer than expected

  Illegal immigrants from Latin American countries are 50% less likely than US-born Latinos to use...

• Create a denials infrastructure

  In order to map out a new denial management protocol at West Virginia University Hospital (WVUH...

• Instituting audits for charity applications

  Over the past year, officials at UNCHCS thoroughly examined every financial process. They...

Issue 26, November 21, 2007

• Health insurance offered by fewer small employers

  According to a Mercer survey released last week, fewer small employers offered health insurance...

• Shortening the wait in ER

  The 143-bed St. Mary's and 300-bed St. Joseph offer acute care, outpatient, and extended care...

• Optimize your discharge planning process

  "A good discharge experience leaves the patient with positive emotions and a strong affinity for...

Issue 25, November 14, 2007

• Medicare to stop paying for some infection treatments

  Medicare will stop paying for treatment of some infections that occur in hospitals and are caused...

• Develop and endorse payment guidelines

  The number of uninsured Americans-47 million and counting-is startling enough without considering...

• Train your employees to ask for money at registration

  In 1991, Mary Rutan Hospital in Bellefontaine, OH, initiated a cash up-front program to give...

Issue 24, November 7, 2007

• Congress passes child healthcare bill again

  Congress voted last Thursday to provide health insurance to an additional 4 million lower-income...

• Simplify your charity care program

  Jeff Shutak has served as the PFS director at The Memorial Hospital (TMH) in North Conway, NH, for...

• Discharge planning: Having patients out by noon

  In most inpatient settings, the same scenario plays out every morning. It's 11 a.m., and patients...

Issue 23, October 31, 2007

• New incentives for doctors to use online records

  The Bush administration is recruiting about 1,200 doctors nationally to omit the paperwork from...

• Improve patient flow

  Like many hospitals, St. Joseph's Medical Center (SJMC) in Townsend, MD, had a universal discharge...

• Streamline the denials process

  West Virginia University Hospital (WVUH) in Morgantown had a way of tracking and managing denials...

Issue 22, October 24, 2007

• States encouraging hospitals to show price lists

  Several states are asking hospitals to disclose their price lists, with the goal to remove some of...

• Verify insurance functions

  Insurance verification and authorization functions involve many factors. With hundreds of differing...

• Incentive plans: Give a little, get a lot back 

  Teresa Bassett, the patient access director at Riverside Health System (RHS) in Newport News, VA...

Issue 21, October 17, 2007

• HHS funds new health information network initiative

  The U.S. Department of Health and Human Services awarded the Indiana University School of Medicine...

• Audit patient access proactively

  As a patient access manager, you know that improving your hospital’s front-end operation is...

• Turn adversity into process improvement initiative

  Accepting criticism is an unpleasant responsibility for any organization. But adversity can be an...

Issue 20, October 10, 2007

• Medicaid spending soars again

  Medicaid costs jumped up 10.7% during the first six months of the year, according to a USA Today...

• Self-service kiosks: A multi-purpose solution

  After Hurricane Katrina struck Louisiana in 2005, closing 75% of New Orleans’ hospitals...

• MD Anderson formalizes patient access functions, tasks

  MD Anderson Cancer Center is a Houston-based specialty hospital providing inpatient and outpatient...

Issue 19, October 3, 2007

• Patients shopping for health care more

  Hospital patients are shopping for bargains and want more information than ever about prices for...

• Strategic pricing: Determine your baseline costs

  Pricing transparency is no longer just an idea for the future of healthcare. Pricing legislation...

Issue 18, September 26, 2007

• Massachusetts to post insurance payments to hospitals online

  Health insurance payments to Massachusetts hospitals will no longer be secret from the public...

• Coping with payer restrictions

  About 31% of large employers-those with 20,000 or more workers-offer HDHPs to their employees...

• Conquer identity theft

  In the healthcare spectrum, two types of theft compromise the integrity of your bottom line and the...

Issue 17, September 19, 2007

• For cancer patients, benefit caps can mean big bills

  Employers and health plans are putting increased caps on the maximum benefits they will pay for...

• Avoid ED overcrowding

  Staff members at the Boston Medical Center (BMC) ED wouldn’t settle for anything less than...

• Improve your revenue cycle IT infrastructure

  Because of the recent shifts from inpatient to ambulatory care, increased claim denials, and the...

• Prepare your hospital for consumerism

  Because so many hospitals haven't utilized a consistent pricing methodology, the process to get up...

Issue 16, September 12, 2007

• Multi-tiered Medicare plans cut prescription costs

  The results of a new study appearing online in the Health Services Research journal indicate that...

• Case management's role in improving patient flow

  In addition to the larger system changes implemented to address patient flow at Lehigh Valley...

• Pricing estimates: Automate your process

  No matter how often your patient access staff explains the myriad of variables that could affect...

Issue 15, September 5, 2007

• Consumers arrange new financing options with doctors

  Millions of Americans have set up payment plans for procedures not typically covered by insurance...

• Postdischarge calls enhance patient satisfaction

  Many experts argue that one of the most effective ways to enhance patient satisfaction during the...

• Seek outside help to ensure payer verification

  It's important seek out multiple services in your area to provide immediate and accurate electronic...

Issue 14, August 29, 2007

• Pediatricians are being left behind as costs increase and commercial insurance reimbursement rates fall

  Commercial insurance reimbursements for physician office visits have barely changed since 2001...

• Bottleneck breakdown: Resolve your discharge process first

  People often point to long wait times in the ED as the source of bottlenecks in the patient access...

• How one facility turned to automated QA and dramatically reversed its error rates

  As a newly installed business office director at a 250-bed hospital with decentralized...

Issue 13, August 22, 2007

• Medicare won't pay for hospital mistakes

  In a move intended to improve the accuracy of Medicare's payment for hospital patients who receive...

• Prepare for POA implementation by following other states' examples

  One way to prepare for the present-on-admission (POA) indicator is to contact hospitals in states...

• Patient throughput

  Overcrowding directly results in diversion. It also frustrates referring physicians, hospital staff...

Issue 12, August 15, 2007

• More hospitals using kiosks to register patients

  The healthcare industry is part of a movement toward adopting technology, such as the use of...

• Defining the role of a physician advisor

  The physician advisor is a relatively new role in hospitals. Five years ago, few hospitals thought...

• Best practices for determining staffing ratios

  Benchmarks for staffing ratios are best internally developed based on a combination of factors...

Issue 11, August 8, 2007

• Swedish Medical Center to stop accepting United HealthCare insurance

  Seattle-based Swedish Medical Center will stop accepting insurance from its patients covered by...

• Check your 2007 reimbursement for specific drugs

  CMS acknowledged incorrect drug payments in the first and second quarters of 2007. This included...

• Discharge delays can lead to patient dissatisfaction

  Delays in discharge have long affected length of stay (LOS) and patient flow, but numerous studies...

Issue 10, August 1, 2007

• Staff training should be a part of providers’ pricing transparency initiative

  Good training doesn’t happen by accident. It requires planning as well as development of a...

• Smiles, improved processes will help maintain and improve your market share

  Retail businesses often say that "the customer is always right." Hospitals are beginning to adopt...

• Seniors' medical literacy could affect life span

  Senior citizens who do not understand the language used in the doctor's office may be at higher...

Issue 9, July 18, 2007

• Rethink your point-of-service collections strategy

  No longer can managers address point-of-service collections half-heartedly and without rethinking...

• Incentive plans: Give a little, get a lot back

  Teresa Bassett, the patient access director at Riverside Health System (RHS) in Newport News, VA...

• Capacity management steps to success

  Once you've determined that your facility has capacity management concerns, IMA Consulting...

• Study: Discharged patients run risk of blood clots

  Hospital patients are at risk for blood clots for the first three months after being discharged...

Issue 8, July 11, 2007

• Consumer-directed plans present new patient issues for access management

  With the consumer in the driver's seat, providers should face the fact that patients won't want to...

• Emphasize the positives when discussing your loan program with patients

  If a patient expresses a need to reestablish credit, or a need for smaller payments, then the loan...

• Study: Cost of healthcare not biggest deterrent for uninsured

  A new study predicts that lowering the cost of health insurance by as much as 50% would only reduce...

• Study: U.S. healthcare consumers getting shortchanged

  A new Commonwealth Fund study suggests that Americans aren't getting the bang for their buck in...

• Note these instances of prohibited ABN use

  Providers cannot obtain routine ABNs from Medicare beneficiaries. Routine ABNs include the...

Issue 7, July 4, 2007

• Physicians group: EDs a significant trouble area

  The nation's emergency departments are overwhelmed, understaffed, underfunded and unready to take...

• Smiles, improved processes will help maintain and improve your market share

  Survey your patients to learn what things annoy them the most and, in turn, what processes you...

• CMS' new

  The most recent Medicare item to affect finance managers is the "Notification of Hospital Discharge...

Issue 6, June 27, 2007

• Tips to find, hire, and maintain front-end help

  If you're dissatisfied with the talent pool from which you currently pull staff, find other pools...

• Medicaid eligibility screening tips

  Medicaid eligibility screening may occur through a variety of approaches, all designed to qualify...

• More hospitals aggressively pursuing payments

  Hospitals aren't denying critical care, but many are becoming stingier about collecting co-pays and...

Issue 5, June 20, 2007

• Upfront collections: Pick your battles wisely

  When it comes to upfront collections, pick your battles carefully. This is not to say that you...

• Demographics a critical component of financial application

  Demographics is one of the major components of any financial assistance application. You’ll...

• OIG withdraws Medicare proposed rule

  On June 18, the OIG published in the Federal Register a notice withdrawing a previous rule proposed...

Issue 4, June 12, 2007

• IPPS proposed rule would benefit some providers, hurt others

  In its proposed rule updating the hospital inpatient prospective payment system (IPPS) for fiscal...

• EMTALA's role in administering ABNs

  A hospital must meet all requirements under the Emergency Medical Treatment and Labor Act (EMTALA...

• CMS issues NPPES notice

  On May 30, CMS published in the Federal Register a notice regarding the National Plan and Provider...

Issue 3, June 6, 2007

• CMS steps toward severity-adjusted DRG payments

  In its proposed rule updating the hospital inpatient prospective payment system (IPPS) for fiscal...

• Be careful how you present your charity care guidelines to patients

  The manner in which you present the charity option is very important. Many individuals may be...

• Henry Ford Health System to make customer billing simpler

  In response to a call for greater transparency, Henry Ford Health System in Detroit will begin...

Issue 2, May 30, 2007

• Charity care: Find balance between internal budget, patient needs

  Officials at The Memorial Hospital (TMH) in North Conway, NH, took several stabs at a...

• Tips for screening patients for charity care

  Factors used to determine the amount of charity service provided include the following: The...

Issue 1, May 23, 2007

• Cash collections: Develop a thorough program for your entire team

  When registrars at Mary Rutan Hospital in Bellefontaine, OH began using a self-pay checklist as a...

• What's NEW on PARC this week!

  Find a management tool to help you and your staff.

• Having trouble appealing your denied claims?

  Please take a moment to complete this short, 10-question survey to tell us how we can develop an...

• ABCs of ABNs

  Be sure to obtain an ABN under the following circumstances: If you expect Medicare to deny payment...

• Consumer-friendly healthcare: Hospital eyes amenities for patients

  Nowadays, strategies to improve customer service and the patient experience are on every access...

• Focus groups, surveys give hospitals first-hand ideas for improvements

  Are you looking for innovative ways to improve the patient experience at your hospital? Go right to...