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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 83, December 31, 2008

• Former Cedars-Sinai employee held for identity theft, fraud

  Cedars-Sinai Medical Center former employee James Allen Wilson, 44, of Los Angeles allegedly stole...

• Crisis in the ER

  Just how is the country’s emergency-room crisis affecting your patient access department...

• Delivering the Advanced Directive form

  How do you deliver Advance Directive forms? Try this way.

Issue 82, December 24, 2008

• CMS launches annual provider satisfaction survey

  It's time to see what providers think of their Medicare contractors.

• Bank VP gets three years in jail for Medicare fraud

  The latest attempt at Medicare fraud was costly for Javier J. Ortiz.

• What's new on PARC?

  Check out our revamped Patient Access Resource Center.

• Download these Revenue Cycle Institute white papers

  The Revenue Cycle Institute announces new and updated white papers available for download.

Issue 81, December 17, 2008

• Play a key role on your facility's RAC team

  Use the holiday season to provide a review session for all access registrars by reviewing a sample...

• Download these Revenue Cycle Institute white papers

  The Revenue Cycle Institute announces new and updated white papers available for download.

• US emergency rooms getting creative

  These days, hospitals must be creative finding ways to cut a patient?s wait time in the ED. USA...

• Insurance verification, self-pay collections improve

  See what this patient access manager has for highlights in 2008.

Issue 80, December 10, 2008

• The challenge of overseeing an EMR system

  Overseeing a new EMR system can be a challenge.

• Obama administration asks for input on healthcare

  President-elect Barack Obama’s healthcare team plans to gather input from concerned parties...

• CMS provides status of PQRI

  CMS published a new report -- "Physician Quality Reporting Initiative (PQRI): 2007 Reporting...

Issue 79, December 3, 2008

• 2008 patient access success

  This revenue cycle manager had a busy year overseeing the admitting department.

• Medicare trust fund may shrink faster

  The Medicare Part A trust fund may be depleted by 2016.

Issue 78, November 26, 2008

• CMS rescinds and replaces previous transmittal on Medicare deductible, coinsurance, and premium rates for 2009

  CMS tweaked its transmittal updating the Medicare deductible, coinsurance, and premium rates for...

• Coping with a major remodel

  One registration manager tells us about coping with a major overhaul of her hospital.

• Unapproved drugs still sold

  Medicaid still covers drugs not reviewed by the government ? about $200 million worth since 2004...

• Inpatient vs. Observation form

  Check out this form the TMF Health Quality Institute uses.

Issue 77, November 19, 2008

• One patient access manager's highlights

  Implementation of a front-end price estimate software application. Realignment of...

• CMS RAC Open Door forum

  CMS announced its intent to make some changes to the RAC program.

• Patients don't understand Medicare coverage gap

  Revenue cycle managers must continue to prepare their staff members to help confused patients with...

• Registration accuracy rates

  Want to know how your peers do with their registration accuracy rates? Want to know if their...

Issue 76, November 12, 2008

• 2008 SUCCESS: One patient access manager’s highlights

  Editor’s note: We asked patient access managers to share with us their success stories from...

• BENCHMARK REPORT: Registration accuracy rates

  Want to know how your peers do with their registration accuracy rates? Want to know if their...

• SNEAK PEEK: Be prepared for ABN changes

  More than a year after several rounds of review on proposed revisions to existing Advance...

• What’s new on PARC?

  Check out our new feature story on enhancing communication in your patient access department.

Issue 75, November 5, 2008

• NEWS: CMS delays RAC permanent program

  CMS yesterday announced it has delayed the Medicare Recovery Audit Contractor (RAC) permanent...

• NEWS: Changes for Medicare drug program

  Older patients may pay more for drugs and co-payments under their Medicare drug-plan premiums next...

• 2008 SUCCESS: One patient access manager’s highlights

  Editor’s note: Last week, Florence Davis, director of Patient Access at Children’s...

• BENCHMARK REPORT: Registration accuracy rates

  Want to know how your peers do with their registration accuracy rates? Want to know if their...

Issue 74, October 29, 2008

• Conduct employee surveys; get rid of manual quality auditing

  "We finally moved away from manual quality auditing to an automated system," this patient...

• CHANGES COMING: Key differences in nationwide rollout

  Now that you know which Medicare Recovery Audit Contractor (RAC) will come to your facility...

• NEWS: MA doctors wanting bonuses required by 2011 to use e-prescriptions

  Blue Cross Blue Shield of Massachusetts is making doctors go to the computer if they want extra...

Issue 73, October 22, 2008

• CMS REPORT: Medicaid spending will rise faster than economy

  Medicaid spending will outpace US growth in the economy over the next 10 years, according to a new...

• WHAT'S NEW ON PARC

  Check out these tips offered by Catherine M. Pallozzi, CHAM, CCS, patient access director at Albany...

• Develop a strong training program

  Develop a training class with input from all those involved, including the attendees, this patient...

• Ask more questions with the MSP

  Speed? Accuracy? Those are important delivering the Medicare Secondary Payer Questionnaire, but if...

Issue 72, October 15, 2008

• RAC UPDATE: Contingency fees announced

  CMS announced the new Medicare Recovery Audit Contractors (RACs) for its permanent nationwide...

• TAKE OUR SURVEY: Registration accuracy: How your peers measure up

  Want to know how your peers do with their registration accuracy rates? Want to know if their...

• Facilities must be prepared for identity theft

  The red flag rule doesn’t specifically reference hospitals, but it does imply that they may...

• SUCCESS STORIES IN 2008: Let us hear it

  By this time, you’ve probably celebrated much success in your patient access department for...

Issue 71, October 8, 2008

• REGISTRATION ACCURACY: How your peers measure up

  Want to know how your peers do with their registration accuracy rates? Want to know if their...

• NEWS: MA residents using ER for routine care

  Patients who acquired state-aided insurance are using emergency rooms in Massachusetts at a higher...

• NEWS: Medicare fraud suspected in Miami

  Federal regulators are investigating charges to Medicare in the Miami area, where government costs...

• 8 tips for quality control auditing

  Whether you use a similar approach or not, here are some helpful tips and reminders from healthcare...

Issue 70, October 1, 2008

• What patient access managers should watch with RACs

  Check out these tips for patient access managers about preparing for a RAC visit. The manager...

• Improving communication at Children's Atlanta

  As in many hospitals, this patient access team's staff members use a variety of methods such as...

• Take-home hints on MSP

  Need hints on the MSP Questionnaire? We've got them.

Issue 69, September 24, 2008

• TIP: Don't forget about MSPs in RACs

  Though CMS officially terminated the Medicare Recovery Audit Contractor Medicare Secondary Payer...

• SPEAKING OF MSP: Tips to monitor staff members’ efficiency

  Check out these MSP tips provided by Stephanie Smithson, CHAM, patient access manager at Dunn...

• Patient access managers must be ready for RACS

  “I strongly urge hospitals to take advantage of this lull in the RAC process to perform gap...

• What's new on PARC this week?

  Check out this scripting tool used by Houston Medical Center in Warner Robins, GA, for collecting...

Issue 68, September 17, 2008

• NEWS: Revised timeline for RACs

  Demand letters from Medicare’s Recovery Audit Contractors (RACs) may be arriving in your...

• CMS releases new ABN instructions

  Providers may still use the revised ABN for all situations in which Medicare payment is expected to...

• NEWS: Hospital settles charges of overbilling

  Staten Island University Hospital settled for fraudulent billing again. For the third time in a...

• Patient access managers chime in on RAC preparedness survey

  Are you and your peers in the revenue cycle fully prepared for the arrival of the Medicare Recovery...

Issue 67, September 10, 2008

• THE FACTS ON RACS: Take our survey!

  HCPro is planning a conference to help organizations manage the nationwide rollout of Recovery...

• NEWS: More people need help with bills

  Americans are not getting any richer. And hospitals continue to realize it. Kay Wagner, the...

• We'll even drive your car for you

  What patient access managers will do for some good, old-fashioned customer service.

Issue 66, September 3, 2008

• Develop a customer service script

  The most difficult part of implementing scripted responses is to develop the appropriate responses...

• SUCCESS IN PATIENT ACCESS: One shoe fits the other

  This patient access team decreased its returned mailings by 30% by correcting address and insurance...

Issue 65, August 27, 2008

• NEWS: New ABN forms not mandatory until March 2009

  You have more time to teach your patient access staff members about the revised Advance Beneficiary...

• SNEAK PEEK: Your MSP checklist

  You have enough to worry about as a patient access manager without the Medicare Recovery Audit...

• Q&A: ABNs and HINNs

  Learn the answer from CMS.

Issue 64, August 20, 2008

• SNEAK PEEK: Customer service recognized at Skagit Valley Hospital

  Editor’s note: The following is a sneak peek of a story that will appear in the October issue...

• ADVISOR'S TIP: Interview candidates twice

  Editor’s note: The following tip is provided by Michael S. Friedberg, FACHE, CHAM, Director...

• BENCHMARK HELP: Send us your thoughts

  Need to know how you measure against your patient access colleagues? Want to know if your results...

Issue 63, August 13, 2008

• ADVISOR'S TIP: Map out co-pay collection process

  Editor’s note: The following is a tip from Debra Keller, admissions/registration director for...

• NEWS: Urgent-care clinics offer ED alternative

  Walk-in urgent-care clinics are seeing a growing number of patients in need of emergency care, the...

• WHAT’S NEW ON PARC THIS WEEK?

  Check out these questions Boca Raton (FL) Community Hospital uses to assess the competency of its...

• TAKE OUR SURVEY: Charity Care

  Dear Health Care Professional, We need your help. HCPro wants to be sure we provide the charity...

Issue 62, August 6, 2008

• YOUR OWN WORDS: Tell us your story, win a prize from PARC

  At the Patient Access Resource Center (PARC), we often hear success stories from the revenue cycle...

• 2008 SALARY SURVEY: Patient access managers overworked

  Charlene B. Cathcart, CHAM, director of admissions and registration at Palmetto Health Richland...

• TEAM BUILDING: Patient access should be ready for RACs

  Some facilities do not include their patient access managers in a RAC audit preparedness team...

• ADVISOR'S TIP: Year-end planning

  Editor’s note: The following is a tip from Catherine Pallozzi, CHAM, CCS, director of Patient...

Issue 61, July 30, 2008

• SNEAK PEEK: MSP RACs claim $12.7 million

  They may not continue them in their nationwide rollout starting in 2010, but the Medicare Secondary...

• BLOG: Is keeping patients waiting in the ER a good business move?

  In this piece from the Wall Street Journal health blog, the author asks whether long emergency room...

• What’s new on PARC this week?

  Getting to know the MSP. To read a story that features important terms and definitions of the...

Issue 60, July 23, 2008

• What's new on PARC?

  Management Tool: Find a registration form used in an ED treatment room.

• Experiment raises doctors' pay to reduce healthcare costs

  Federal and private insurers across the country are carrying out an experiment to cut healthcare...

• Develop financial scripts with your patient access staff

  Staff members need to know how to discuss financial issues with patients. Scripting is the basic...

• Have MSP resources on hand to help ensure compliance

  Eugene Cepeda, a senior consultant of revenue cycle at BESLER Consulting, identifies the main...

Issue 59, July 16, 2008

• Concierge healthcare rising in popularity

  In a growing trend, primary care physicians are turning to concierge medicine, the Austin Business...

• Full report on 2009 OPPS proposed rule

  CMS’ Outpatient Prospective Payment System (OPPS) proposed rule for fiscal year (FY) 2009...

• Are you prepared for Medicare's RACs?

  Want to know how prepared your peers are for Medicare’s Recovery Audit Contractors (RACs...

• PARC salary survey

    As a patient access manager, you constantly balance the needs of your staff and the duties...

• Tip: Create a managed care plan matrix

  It is useful to have a contracted insurance matrix that access staff members can use as a reference...

Issue 58, July 9, 2008

• Healthcare shoppers go undercover

  As the competitive edge between hospitals and healthcare providers increases, "secret"...

• Process for bedside registration in the ED

  York (ME) Hospital finds bedside registration in the ED one of the most effective tools to ensure...

• PARC salary survey

  As a patient access manager, you constantly balance the needs of your staff and the duties of the...

Issue 57, July 2, 2008

• News: Medicare fee cut halted

  The Bush administration said on Monday it is freezing a 10% fee cut for doctors who treat Medicare...

• Take our PARC salary survey.

  As a patient access manager, you constantly balance the needs of your staff and the duties of the...

• Tip: Medical necessity appeals: Include detailed patient information

  The most compelling aspect of a medical necessity appeal will be that of patient medical records...

• Tip: Find the right software for better registration flow

  When looking at software to improve registration, Laurie Wolf, patient registration manager at the...

Issue 56, June 25, 2008

• Medicare details patients' hospice rights

  New CMS regulations allow beneficiaries the right to determine their hospice care, Reuters...

• Seven tips to minimize medical identity theft

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

• Tips for charity care screening

  Successful charity care screening begins with understanding your facility’s charity policy...

Issue 55, June 18, 2008

• Blue Cross signs on with Google Health

  Google’s online medical data storage site, Google Health, obtained its first participating...

• Ensure valid physician orders

  With a few exceptions, such as flu, pneumonia vaccines, and screening mammograms, scheduled service...

• Important Message delivery

  Patient financial liability is not the only concern requiring inpatient notification. As a patient...

Issue 54, June 11, 2008

• BENCHMARKING REPORT: 2008 Recruitment and Retention report from PARC

  As a patient access manager, recruitment and retention of quality staff is crucial. What is your...

• HCPro at ANI conference

  HCPro’s finance editorial team will be at HFMA’s 2008 ANI: The Healthcare Finance...

• Tennessee facilities move to kiosks

  Two Tennessee healthcare facilities are the latest to begin to use self-service kiosks...

• When to use the HINN 11

  Here are examples of when to use the HINN 11.

• What's new on PARC this week!

  Check out our new HIPAA training tool for registration staff. To download the tool, click here.

• Ranks of underinsured are rising, study finds

  The number of U.S. residents who have health insurance but not the ability to afford adequate...

Issue 53, June 4, 2008

• What's new on PARC this week?

  Find a training tool to help your staff with HIPAA compliance.

• Health insurance companies to offer their members cost estimates

  The Wisconsin Association of Health Plans announced last week that 17 of its health insurance...

• Start a KPI program

  Key performance indicators (KPIs) are performance metrics that you use to manage your portion of...

• "Right-size" your staffing levels

  The key to staffing is knowing that you have right-sized your complement of staff. There are two...

Issue 52, May 28, 2008

• Study on COPD management shows decreased admission rates

  A recent study has shown that a different approach to management of people with chronic obstructive...

• Understand the rules to collect full reimbursement and remain compliant

  The Medicare inpatient notification process, including notices related to limitation on liability...

• Help your registration staff remain HIPAA-compliant

  “Your front desk staff touch with HIPAA at all different levels,” says Lisa Simmons...

Issue 51, May 21, 2008

• News: Flash drive holds patient records

  A flash drive that will store all of a patient’s health records and be accessible through any...

• Tip: Get started creating training scripts

  Developing scripts begins with creating a master list of situations and questions for which scripts...

• Tip: Establish copay procedures

  Providers are generally required to have credit and collection policies, and everyon in the...

• Take our short MSP survey and receive a Starbucks gift card!

  Take our short MSP survey and receive a Starbucks gift card!

Issue 50, May 14, 2008

• NEWS: Medicaid Cash and Counseling program expanding

  Cash and Counseling, the Medicaid option that gives elderly people the funds to hire their own help...

• TIP: Handle patient calls effectively

  T.T. “Mitch” Mitchell, president of T.T. Mitchell Consulting, developed these five...

• TIP: Develop a patient screening process for payment plan eligibility

  The most effective payment plan programs begin with a screening to determine whether the patient...

• It was great to meet you!

  It was great to meet you!

Issue 49, May 7, 2008

• NEWS: Health savings plans attracting more enrollees

  Health savings accounts—insurance plans with savings accounts—have seen nearly twice...

• TIP: Understand the fine print of the new ABN

  CMS states that it will provide a few versions of the new form: a generic ABN and alternative...

• TIP: Ensure Advance Directive form compliance

  Advance Directive forms most often are presented by patient access staff members. But any lack of...

Issue 48, April 30, 2008

• House votes down Medicaid cutbacks

  The House voted last Wednesday to stop the Bush administration from cutting federal spending on...

• Form a pricing list

  In an age of competitive healthcare in which patients shop more than they ever have, some access...

• Constructing a new policy and procedure manual

  lthough it took two years to finish, for Cathy Pallozzi, CHAM, CCS, director of patient access at...

Issue 47, April 23, 2008

• Massachusetts receives $4.6M grant

  CMS awarded Massachusetts a $4.6 million grant to control healthcare costs by minimizing...

• Decrease denied claims

  Before approaching a managed care company to address a technical denial or a clinical denial...

• Develop scripting to train staff on cost estimates

  The focus of the new ABN training should be on the new requirement for access staff members to...

Issue 46, April 16, 2008

• Tip: Three ways to start using physicians in a denial program

  Here are three options to consider if you decide to make physician participation a regular part of...

• Tip: Prepare for cost estimate training with new ABNs

  Patient access managers must train their representatives to adapt to the new Advance Beneficiary...

• Take our short survey and be entered to win $100.

  As a patient access manager, recruitment and retention of quality staff is crucial. What is your...

• HCPro at the NAHAM Conference

  HCPro’s editorial team will be at the NAHAM Annual Conference and Exposition in May, and we...

Issue 45, April 9, 2008

• News: Medicare and Medicaid funds distributed

  CMS will give the Tennessee Health Insurance Assistance Program $793,699 to help Medicare...

• Tip: Use phone scripting to improve charity care collections

  In the preservice area, staff members need to know how to discuss payment options with patients who...

• Tip: Central scheduling: A proven incentive program

  Linda Hogel, RN, project coordinator for access and care management at TriHealth, Inc., Good...

• Got ideas?

  Need to know how you measure against your colleagues? Want to know if your results are on pace with...

Issue 44, April 2, 2008

• News: CMS loosens home-based health services payment rules

  The U.S. Centers for Medicare and Medicaid Services said last week that thousands Medicaid patients...

• Tip: Increase your facility's copay collections

  Collecting copayments will not make hospitals rich. "Collecting copays up front doesn't really do...

• Tip: Guidelines for fair and accurate debt collection

  Chasing private-pay patients to collect delinquent bills can be frustrating, and it could backfire...

• GOT IDEAS? PARC needs your help with benchmarking reports

  Need to know how you measure against your colleagues? Want to know if your results are on pace with...

• And the winners are:

  HCPro's Patient Access Resource Center has selected its winners after its search for access staff...

Issue 43, March 26, 2008

• Medicare cuts supply prices

  Taxpayers and Medicare beneficiaries could save more than $1 billion a year as the Bush...

• Tip: Conduct a chart audit

  Hospitals are susceptible to the greatest losses in the area of medical necessity for outpatient...

• Tip: Assess customer service skills

  The burden to train representatives falls on the access manager. When representatives fail to meet...

Issue 42, March 12, 2008

• News: UNC ramping up efforts to collect payment

  UNC Health Care is again increasing their efforts to collect money from patients, less than two...

• Tip: One-on-one training

  Stephanie Smithson, CHAM, patient access manager at Dunn Memorial Hospital in Bedford, IN, had one...

• Tip: Setting up an incentive program

  Marilyn Lipka, vice president of Wolfskill & Associates, a national healthcare revenue cycle...

• Benchmarking report: 2008 self-pay report from PARC

  Self-pay patients are a fact of life. Getting them to pay is, too. The Patient Access Resource...

• What's new on PARC this week?

  Find a management tool one facility uses to help ensure registration accuracy.

• News: Hospitals check credit to see if patients can pay

  An increasing number of hospitals are scanning patients’ personal financial information in an...

• Tip: Help your staff with MSP questionnaire compliance

  The main hang-ups patient access staff members have with the Medicare Secondary Payer (MSP...

• News: Medicare releases changes to ABNs

  CMS Releases New ABN By William Malm, ND, RN In a much anticipated move, CMS released the new...

• PARC Contest: Write us about your best access rep or manager

  Tell us your story, win a prize

• Announcement: New HCPro logo

  HCPro, Inc. launches new logo and tagline as part of its new corporate branding initiative.

Issue 41, March 5, 2008

• NEWS: Shortage of healthcare workers predicted

  More than 250,000 additional US public health workers will be needed by the year 2020, the...

• What's new on PARC this week!

  See how one facility trains its access representatives to interact with patients in the ED.

• TIP: Solutions from measuring accuracy rates

  The patient access manager wants solutions from measuring registration accuracy rates. But is it OK...

• TIP: Uniforms go a long way for access reps

  In the world of patient access, does it matter what you wear?

Issue 40, February 27, 2008

• Medicare expands coverage of ailing hearts

  Medicare is proposing two changes in coverage for people with heart problems, the Wall Street...

• The Move to Decentralization

  Wait times are shorter in decentralized. After all, if you are there for a laboratory test, and...

• Q&A on accuracy rates

  In 2007, the patient access advisor conducted a survey with access professionals about registration...

• Q&A on accuracy rates

  In 2007, the patient access advisor conducted a survey with access professionals about registration...

Issue 39, February 20, 2008

• Officials face challenges in providing care to uninsured

  The number of adults without medical insurance has continued to rise, and officials across the...

• Pricing estimates: Automate your process

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

• Increase productivity through employee incentives

  Beverly McCauslin, manager of central scheduling and communication support for TriHealth, Inc...

Issue 38, February 13, 2008

• City hospitals work to improve emergency rooms

  New York City hospitals and others in cities across the nation are spending hundreds of millions of...

• Set achievable goals for an incentive program

  Marilyn Lipka, vice president of Wolfskill & Associates, a national healthcare revenue cycle...

• Transparency key to delivering Advanced Directive

  It all comes back to the front end in the healthcare revenue cycle. It is certainly true with...

Issue 37, February 6, 2008

• Medicare's drug program enrollment growing

  The number of enrollees in the three-year-old Medicare Part D drug program is climbing, even as...

• Evaluate vendor options

  Instead of acting as a bank and loan servicer, most hospitals are turning to experts in automated...

• Retail healthcare clinics

  Retail healthcare clinics, which promise consumers shorter lines and lower costs, are the newest...

Issue 36, January 30, 2008

• States push for healthcare reform

  An estimated 47 million Americans often forego necessary medicine and medical care. With the...

• Explore payment plan options

  The problem of unpaid bills is only getting worse for organizations, but there are measures that...

• Identify registration errors

  From Paul Shorrosh, MSW, MBA As a newly installed business office director at a 250-bed hospital...

• Identify registration errors

  From Paul Shorrosh, MSW, MBA As a newly installed business office director at a 250-bed hospital...

• What’s new on PARC this week!

  Find a management tool to help you and your staff.

Issue 35, January 23, 2008

• Enter to win $100 for taking our self-pay survey

  Enter to win $100 for taking our self-pay survey

• Patient logistic system

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

• Manage patient throughput

  Poor patient throughput is common in hospitals nation-wide, large and small, rural and urban. EDs...

• Blue Cross aims to lower costs and improve quality

  Blue Cross and Blue Shield of Massachusetts is proposing to change the way it pays doctors and...

Issue 34, January 16, 2008

• Hospitals face ER overcrowding

  The American Medical Association says the US is facing a potential crisis in emergency care...

• Incorporate the IM process and show compliance

  In the HCPro audioconference "The Important Message from Medicare Regulation: Typify your process...

• 2008 OPPS final rule

  CMS released the 2008 OPPS final rule (CMS-1392-FC) on November 1, 2007, and it took effect January...

Issue 33, January 9, 2008

• Survey shows consumers care about pricing data

  Consumers care about health care prices and quality, and will shop around if they’re provided...

• Incorporating the Important Message from Medicare (IM)

  In the HCPro audioconference, "The Important Message from Medicare Regulation: Typify your...

• Devise a scheduling system that works for your employees

  How do managers keep their staff members happy? Their schedules are a good place to start.

Issue 32, January 2, 2008

• US ruling supports benefit cut for retirees

  The Equal Employment Opportunity Commission announced last week that employers could decrease or...

• UNCHCS monitors initiative progress

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

• Discharge planning

  What's actually keeping hospitals from early discharges? According to Bud Pate, REHS, practice...