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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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2009 | 2008 | 2007

Patient Access Weekly Advisor

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...

• Benchmarking in patient access

  These days, it seems all patient access departments are ramping up efforts to be accurate...

Issue 42, October 21, 2009

• Establish a relationship with patient financial services staff

  Establishing a relationship with PFS counselors can help case managers in their role as patient...

• 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...

• Tip: Work with patients who demand admission

  This document informs the patient that he or she does not meet the criteria for an inpatient stay...

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.