Free Revenue Cycle e-Newsletters

APCs Weekly Monitor CDI Strategies Coding Educator Compliance Monitor Healthcare Auditing Weekly HealthLeaders Media Corner Office HealthLeaders Media Finance Medicare Update for Physician Services Medicare Weekly Update Patient Access Weekly Advisor Patient Financial Services Weekly Advisor The RAC Report

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.

Subscribe »

2012 | 2011 | 2010 | 2009 | 2008 | 2007

Patient Access Weekly Advisor

Issue 52, December 30, 2009

• CMS says readmissions pilot program is working

  The American Case Management Association (ACMA) Public Policy Committee surveyed nearly 400 case...

• Senate passes health reform bill

  In the morning hours of Christmas Eve the Senate passed the Patient Protection and Affordable Care...

• Automatic denial of codes billed with -GA modifier

  We previously discussed Transmittal R1840CP implementing a new modifier and instructions for...

• Steps to consider when preparing for RACs

  Preparing a team to deal with RACs will better equip your organization to manage the audits.

Issue 51, December 23, 2009

• Hospital-SNF readmissions study results

  Results of a nine-month HCPro transition-of-care study available now on CaseManagementMentor.com

• Pilot program identifies the cause of frequent ED visits; patients overcome barriers

  University Health Care Center (UHCC) in Syracuse, NY modeled its program for handling frequent ED...

• Tip: Help prepare your facility for RACs

  Medical necessity will compose a big part of the RAC audits, Twist says. The admitting department...

• Carts for bedside registration

  Check out this Patient Access Resource Center blog post that has your colleagues talking.

Issue 50, December 16, 2009

• Carts for bedside registration

  Find out what your colleagues are talking about on our Patient Access Resource Center.

• Survival in a new era of enforcement a tall order for hospitals

  The struggling economy has left many hospitals with thin wallets, and government auditors are...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers. We hope...

Issue 49, December 9, 2009

• Facilitating open communication

  Before communicating with PAs, decide beforehand the type of response you expect in certain...

• Region C RAC posts DRG validation issues

  Connolly Healthcare, the RAC for Region C, has added at least 24 DRG validation issues to its list...

• Flurry of HIPAA activity expected over next three months

  HHS, which oversees OCR, is in the process of trying to put out a fair number of rules, from what...

• Survey: Health costs, reform a source of stress for Americans

  The Health Care in America survey also concluded that the healthcare reform debate is a cause of...

Issue 48, December 2, 2009

• Medicare deductibles and coinsurance for CY 2010

  CMS recently published the Part A deductible and coinsurance and Part B deductible amounts for CY...

• CMS provides guidance on voluntary use of ABNs

  In a recent transmittal (R1840CP), CMS provides guidance on the voluntary use of ABNs.  ABNs...

• Revenue Cycle Institute releases free RAC Preparedness Benchmarking Report

  Budgets are tight, but it seems that many healthcare providers are aware that setting aside...

• CMS releases five new, updated RAC FAQ

  CMS released several new and updated FAQ on its Web site November 17.

Issue 47, November 25, 2009

• TIP: Avoid vague education on communication devices, Web sites

  You can protect your organization by investing in communication devices such as BlackBerry®...

• Inpatient satisfaction growing in US

  The number of patients satisfied with their inpatient care has steadily risen in each of the last...

• CMS issues billing guidance on voluntary use of ABNs

  Check out this billing update to issuing ABNs.

• Senate health reform bill expands RAC program to Medicaid, Medicare Parts C and Ds

  Similar to the current Medicare RAC program, the Medicaid RACs would be paid by contingency fee to...

Issue 46, November 18, 2009

• New HIPAA whitepaper!

  Check out our new whitepaper, our third on HITECH-related regulations and laws.

• Q&A: Red Flags Rule

  Learn the answer to this tough compliance question.

• Have you been audited by a RAC?

  If you’ve been audited by a RAC–for example, perhaps you’ve received a demand...

• House approves healthcare reform bill

  The U.S. House of Representatives recently passed the healthcare reform bill (HR 3962) by a narrow...

Issue 45, November 11, 2009

• HINNs help with difficult cases

  Patients sometimes refuse to participate in the discharge planning process as a clever way to delay...

• Region D RAC posts updated audit issues, CMS issues H1N1 memo, and more

  On November 6, CMS issued a memo regarding recent developments to waive certain statutory and...

• Red Flags Rule enforcement delayed to June 1

  The previous delay announcement—from August 1 enforcement to November 1—came in July...

Issue 44, November 4, 2009

• Small healthcare entities need Red Flags the most

  The House of Representatives unanimously passed a bill October 22 that would exempt a healthcare...

• Build accountability into your Revenue Cycle

  It can be good to compare nationally or even regionally, but some of the best benchmarks are right...

• Transmittals and MLN Matters articles: CMS instructs on billing for voluntary ABNs, issues RAC transmittal, and more

  On October 30, CMS issued a transmittal to the Medicare Financial Management Manual pertaining to...

Issue 43, October 28, 2009

• Five last-minute tips to prepare for RACs

  RACs have begun auditing at this point, and providers in some states may have received their first...

• Is H1N1 hype clogging your ED?

  The nightly news is teeming with stories about seemingly healthy young individuals becoming...

• Houses passes Red Flags Rule amendment bill

  The Red Flags Rule, which will be enforced starting November 1, 2009, requires healthcare entities...

Issue 42, October 21, 2009

• Another Medicaid reduction possible when stimulus funds are gone

  The decline in tax revenue and increase in Medicaid enrollment combined to put the squeeze on the...

• AHA RAC Program Update answers provider questions

  As of September 18, all four RACs were conducting automated audits, according to an October 6...

Issue 41, October 14, 2009

• Identifying emergency department ’regulars’ can improve throughput

  It’s safe to say that every emergency department (ED) sees its fair share of “frequent...

• Are you holding your team accountable?

  Do you hold your patient access team accountable?

• CMS releases new RAC FAQ

  CMS released the following new RAC FAQ September 25: How long is the Recovery Audit Contractor...

Issue 40, October 7, 2009

• Patients, docs rip ED waits in Massachusetts

  In an ACEP Internet poll of 138 Massachusetts emergency physicians conducted last month, 51% of...

Issue 39, September 30, 2009

• Looking for information on the CHAA

  Your colleague needs some help on the CHAA.

• Getting more out of your revenue cycle

  Want to get more out of your revenue cycle? Start on the front end.

Issue 38, September 23, 2009

• Revenue Cycle Institute launches new Web site, posts new RAC tool

  We’ve gathered the latest RAC information on the CMS-approved RAC issues in each state and...

• Feds unsure over HIPAA enforcement practices

  It seemed as if they were serious about enforcement. After all, it took them less than 24 hours to...

• Download your FREE on-demand MedicareFind webcast

  Please accept this invitation to obtain a FREE on-demand webcast of our recent MedicareFind...

• Last RAC announces first issues for audits

  The RAC field is set.

Issue 37, September 16, 2009

• What are the benefits of using whiteboards to track patient discharges?

  Imagine a communication tool in patient rooms that allows interaction between the patient, his or...

• Inpatient HINNs - Protecting the hospital’s right to recover payment for non-covered services

  Under Medicare’s limitation on liability (LOL) provisions, hospitals are required to provide...

• Confront, correct, counsel disruptive physicians

  Disruptive behavior can be caused by many factors, internal and external. The troubled physician...

Issue 36, September 9, 2009

• Region B RAC posts first set of approved audit issues

  CGI Federal, the RAC for Region B, has posted its first set of issues eligible for RAC audits in...

• Download your FREE on-demand MedicareFind webcast

  Please accept this invitation to obtain a FREE on-demand webcast of our recent MedicareFind...

• MACs vs. RACs: could competition mean more bad news for providers?

  Might there be a little friendly competition between RACs and MACs?

Issue 35, September 2, 2009

• Free RAC tracking tool sample

  Have you developed a way to manage the complex task of tracking your RAC requests and appeals? If...

• Patient deportation case highlights issues with illegal alien healthcare

  A medical ethicist says people who are angry at a South Florida hospital for repatriating a...

• Health coverage does not protect against incurring medical debt

  The nation's largest state health survey was conducted by the UCLA Center for Health Policy...

Issue 34, August 26, 2009

• Going low tech might reduce costly hospital admissions in chronic heart failure

  It turned to a concept that uses surprisingly simple technology: a scale and a telephone, to learn...

• HHS puts more teeth into HIPAA regulations

  New breach notification laws have been released by HHS.

• Use these phrases to avoid conflict with patients, families, colleagues

  This week’s tip comes from Karen Zander, RN, MS, CMAC, FAAN, principal and co-owner of The...

Issue 33, August 19, 2009

• Question on the preadmission/admission HINN

  Confused about the HINN inpatient form? Get the scoop here.

• HealthDataInsights launches new RAC Web site, posts issues eligible for audits

  The list of issues will likely be familiar to healthcare providers who saw those announced by...

Issue 32, August 12, 2009

• Surprise! Voluntary refunds don’t protect against RACs

  For many providers, self-auditing has become an important RAC preparation tool. Certainly, internal...

• Check out our new HIPAA Update blog!

  Welcome to our new HIPAA Update blog -- your one-stop shopping for HIPAA privacy and security...

• Health card companies defrauding hospitals and patients shut down

  If the practice isn't stopped, patients will continue to have their credit records tarnished for...

Issue 31, August 5, 2009

• RACs officially set to begin

  Providers should anticipate that RACs will audit for different issues for different jurisdictions...

• Red Flags Rule deadline pushed back again

  The additional three months—which comes at the request of the House Appropriations...

• EDs can’t sustain care in current economic environment

  Of all visits to hospital emergency departments in 2006, 41.8% of the care was billed to the...

Issue 30, July 29, 2009

• Emergency docs say Sebelius is wrong about ED

  Sebelius said statistics from a database managed by the Agency for Health Research and Quality show...

• Tip: Steps for Red Flags Rule compliance

  Red Flags Rule enforcement date comes Saturday, August 1. Are you ready?

• Individual insurance market falls short for families

  Those with coverage obtained from the individual market were the most affected, the report said

Issue 29, July 22, 2009

• CMS Releases RAC Audit Phase-in Strategy: Complex reviews to arrive as soon as August

  CMS released further information June 24 on its RAC Web site letting healthcare providers know when...

• Have you had an experience with Medicaid Integrity Contractors?

  If you’ve had experience with Medicaid Integrity Contractors (MIC), we want to hear from you!

• Sign up for our FREE MedicareFind webcast!

  Get the most out of MedicareFind by watching our demonstration of how to access primary authorities...

• Medicaid beneficiary fluctuations are leading to more costs

  With so many people "churning," which means dropping out and back in to the Medicaid...

Issue 28, July 15, 2009

• 3.5 million new healthcare jobs expected by 2016

  Even with a slower growth rate of spending, the expected expansion of health coverage could lead to...

• Hospital’s pre-registration efforts pay off in collections

  If you don't get them before they come in the door, you will probably see long lines in the...

• Revenue Cycle Institute posts free ABN Audit Preparation tool

  Your patient access team would benefit from this ABN tool.  

Issue 27, July 8, 2009

• HHS makes $40 million available to cover uninsured children

  This grant announcement is the first cycle of outreach funding under the new Children’s...

• Care Card technology improves health system’s patient flow and waiting time

  In 2006, this hospital implemented electronic kiosks along with a Care Card to help the...

Issue 26, July 1, 2009

• RAC complex reviews to arrive as soon as August

  When are the RACs coming? CMS let us in on the schedule.

• Hospital’s ’what if’ scenario becomes reality

  Skagit Valley planned for a worst-case scenario financially. Then it happened.

• Key questions about an insurance exchange

  Supporters of the various insurance exchange programs agree that the program would provide one-stop...

• PARC hot topic

  See what they're talking about on the Patient Access Resource Center.

Issue 25, June 24, 2009

• ED wait times drop slightly; patient satisfaction rises

  Patient satisfaction is rising despite growing economic woes.

• Patient access leaders must remain flexible in difficult economy

  In tough economic times, managers are doing the work they once managed.

• MedicareFind.com launches

  MedicareFind is an easy-to-use Web site to help you navigate through and find Medicare-related...

Issue 24, June 17, 2009

• New infection control product monitors whether staff members perform hand hygiene

  Performing hand hygiene adequately and often is something that many healthcare facilities are...

Issue 22, June 17, 2009

• From HFMA: Five ways leaders fail

  Patient access managers are always looking for new leadership advice. And here is some fresh stuff...

• Have a RAC question? CMS has some answers

  Have RAC questions? CMS may have the answers. New updated questions have been released.

• Blog about patient access

  Come blog with us -- and your patient access colleagues.

Issue 21, June 3, 2009

• CMS updates RAC audit timeline: complex reviews still months away

  Get ready for RAC automated reviews this month and next.

• Patient access teams get financially smart in a tight economy

  What are patient access teams doing in a recession? Getting smarter.

• Hospital uses EMR to improve handoff process and create electronic ’hall pass’

  See how one hospital stayed in compliance with the National Patient Safety Goal concerning handoff...

• Double-digit rate hikes projected for health plans

  Private healthcare plans are getting more costly. Much more costly.

• Take our survey; Be part of a comprehensive look at national RAC preparedness

  What is your facility doing to prepare for a RAC? We want to know.

• Red Flags Rule: Comply now, avoid lawsuit later

  Red Flags Rule compliance must start now.

• Our benchmarks in patient access accuracy

  How do you measure up against your peers in terms of registration accuracy.

Issue 20, May 27, 2009

• CMS releases new RAC FAQ

  CMS has a new RAC Q&A.

• Our benchmarks in patient access accuracy

  Check out these numbers about patient access accuracy in our benchmarking report.

• Proposal would require health plans, doctors to cut appointment wait times

  The latest talk has one state mandating maximum wait times.

• Medicare payment changes could prompt hospital closings, layoffs

  New Jersey could be in for big losses if a Medicare payment rule goes through.

Issue 19, May 20, 2009

• Processing your MSP claims

  Some need-to-know messages about the MSP from CMS.

• Is healthcare better without doctors?

  Medical devices. Over-the-counter drugs. Who needs docs anyway?

• Hospitals increasing focus on patient satisfaction, but many questions remain

  A lot of questions remain about how best to measure, manage, and define patient satisfaction.

• Americans want answers on health reform impact

  Americans want healthcare reform. What kind? The jury is still out.

Issue 18, May 13, 2009

• State requirement mandates doctors post digns telling patients who licenses them

  In an era of increasing transparency, this one may top them all.

• Sebelius names Office of Health Reform personnel

  An HHS team is in place.

• Recovery Audit Contractor Defense conference recordings available

  Recordings of the following RAC sessions are now available.

Issue 17, May 6, 2009

• HIPAA and the HITECH Act: Strategies for success

  All you need to know about the HITECH Act.

• Red Flags Rule enforcement delayed until August 1

  You have more time to implement your Red Flags Rule and get your patient access team up to speed on...

• CMS posts RAC Open Door Forum call transcript, recording

  Get your CMS minutes from its RAC call here.

• 100% MSP compliance

  Want perfect compliance with the MSP? This facility can teach you.

Issue 16, April 29, 2009

• HIPAA and the HITECH Act

  Your patient access staff members must be in the loop about the new HIPAA laws.

• Patient access benchmarks. Take our survey!

  We want to know how you feel about benchmarks in patient access.

• Hospital job growth flat-lines in 2009

  Job growth is obviously low -- and hospitals are not off the hook.

Issue 15, April 22, 2009

• HINNs case study of success

  Your success story working with the HINNs should be told.

• Business associates: HIPAA survey

  Do your business associates have enough HIPAA training? We want to know.  

• Patient access benchmarks. Take our survey!

  We want to help you get to your benchmarks in patient access. But first, help us by taking this...

Issue 14, April 15, 2009

• HINNs case study of success

  If you got a success story about HINNs, we want to know about it.

• CMS Open Door Forum conference call rescheduled for April 22

  Get the date for the next CMS Open Door Forum.

• Red Flags Rule guidance published

  Red Flags Rule compliance is coming. Are you ready?

• Patient access benchmarks: take our survey!

  Take this survey to help us compile information on patient access benchmarks.

Issue 13, April 8, 2009

• HINNs case study of success

  If you've got an excellent case study, we want to hear it.

• Tell us your story, win a prize from PARC

  You have a solid patient access department? This is your chance to get it some recognition.  

• Q&A: RACs and critical access hospitals

  Learn this important answer to a question about critical access hospitals and RACs.

Issue 12, April 1, 2009

• New provider posts on PARC!

  Check out the most fresh posts on the Patient Access Resource Center.

• Q&A: ABNs

  What you need to know about the Advanced Beneficiary Notice and the claim form.

• Tell us your story, win a prize from PARC

  This is your chance to show off your patient access department's success.

• Billing post-denials

  Post denials are no joke.

Issue 11, March 25, 2009

• Accurate edits return $$$

  By Vince Arencibia and Julie Souder   Many companies offer various services and ideas on...

• 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.

• New provider posts on PARC!

  Our revamped Patient Access Resource Center Web site has seen a steady flow of traffic from...

• Q&A: RACs and readmissions

  Q: A provider does three different procedures in three different days. Is this acceptable? Are RACs...

Issue 10, March 18, 2009

• Tell us your story, win a prize from PARC

  We want to hear your patient access success story.

• New provider posts on PARC!

  Check out what your colleagues are saying on our Patient Access Resource Center.

• Tip: Use these strategies to get ready for RACs

  Start to get your patient access team RAC ready with these tips.

• Revenue Cycle Institute update

  Check out this new tool to help your quality assurance checks with your patient access departments.

Issue 9, March 11, 2009

• Tell us your story, win a prize from PARC

  You have success stories in your patient access department. We want to hear about them.

• New provider posts on PARC!

  See what your patient access peers are discussing on our PARC blog.

• CMS rescinds and replaces previous RAC transmittal

  Keep up to date with RAC transmittals like this one.

• Q&A: HIPAA and whiteboards

  Know these rules when writing a physician's name on a whiteboard.

Issue 8, March 4, 2009

• Tip: Tune in to RAC outreach sessions and town hall meetings

  The time is now to be on the lookout for important CMS announcements regarding RACs.

• New provider posts on PARC!

  Check out all our new posts from your peers on the Patient Access Resource Center.

• Report issued on privacy protections applicable to electronic information

  This report tells you about the pitfalls of exchanging information electronically.

Issue 7, February 25, 2009

• Provider posts on PARC!

  Our revamped Patient Access Resource Center Web site has seen a steady flow of traffic from...

• Study indicates big rise in federal healthcare spending

  A federal study shows that government healthcare spending is expected to increase to $1.191...

• Healthcare summit concludes with pledge

  The White House “fiscal responsibility summit” wrapped up this week with a pledge to...

Issue 6, February 18, 2009

• New provider posts on PARC!

  Check out these new posts on the Patient Access Resource Center!

• Tip: Address one-day stays before the RAC permanent program begins

  All you need to know about RAC compliance with one-day stays.

• Understand the intricacies of medical necessity

  Medical necessity is complex. But you need to be better at understanding it come RAC time.

Issue 5, February 11, 2009

• New provider posts on PARC!

  Providers are busy talking about patient access issues on our Patient Access Resource Center.

• CMS resolves RAC protest; permanent program moves forward

  The time for RAC implementation is now. That’s because CMS lifted the moratorium on the...

• Take-home hints on the MSP

  Use these Medicare Secondary Payer tips in order to remain compliant and obtain full reimbursement.

• Stimulus plan will kick in millions to Medicaid

  The economic stimulus plan passed by the Senate means millions more for Medicaid.

Issue 4, February 3, 2009

• Prepare for approaching ABN deadline

  Mandatory use of the new ABN form will be here before you know it.

• New and improved Patient Access Web site!

  Check out our new Patient Access Web site!

• Medicare data won't be released

  One consumer group wants to open the billing process at hospitals in order to expose Medicare waste...

• Aetna Inc. to reimburse students

  It pays to be a college student getting insurance from Aetna Inc.

Issue 3, January 28, 2009

• New and improved Patient Access Web site!

  The Patient Access Resource Center has changed to meet your needs. We went to a blog format in...

• Patient access meets patient financial services

  Part of the challenge of a patient access manager is developing a functional working relationship...

• Medicaid battle brews in Minnesota

  Minnesota has a problem -- Medicaid spending is getting out of control, and the Legislature wants...

• ER intends to serve older patients

  This hospital’s ER is catered to seniors, what many believe to be the first of its kind.

Issue 2, January 21, 2009

• Obama will ease restraints on states’ health insurance programs for children

  President-elect Barack Obama will change a Bush administration policy to provide more access to...

• ED bedside registration: when it does not work

  Bedside registration in the ED either works or does not work for a revenue cycle department. For...

• Report: CEO confidence at all-time low

  The view from the top does not look so promising in this economy.

• Obama promises quality; Dunn Memorial already delivers

  Inauguration speeches are all about promises. Dunn Memorial Hospital’s patient access team...

Issue 1, January 14, 2009

• Coming soon

  This month, HCPro, Inc. will unveil a new look for the Patient Access Resource Center Web site. We...

• ED bedside registration: when it does work

  Think ED bedside registration can work for you? It has for this provider.  

• Massachusetts governor weighs insurance hearing

  Note from the governor: Slow down on raising health insurance. That’s what is happening in...

• WellPoint barred from enrolling new patients in Medicare

  Wellpoint, Inc. is paying the price for denying prescription drugs to the elderly -- it can no...

Issue 84, January 7, 2009

• National health spending growth at slowest pace since 1999

  Americans are not reaching into their wallets on healthcare.

• Download these Revenue Cycle Institute white papers

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

• Winner in patient access

  The best patient access has to offer.