Hospital Access Management – December 1, 2010
December 1, 2010
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Health care reform will revamp patient access: Get ready now
There will be dramatic changes in the works for patient access departments as a result of health care reform legislation. That is for certain. But many important details are still unclear. -
Confused by tech pitches? Sort through the hype
Does a system claim to be the "be all, do all" for your patient access department's issues, such as an eligibility system verifying benefits for all payers? If so, be skeptical. -
Collaborate to stop 'no authorization' denials
Reasons for claims denials often can be traced back to factors beyond patient access, such lack of medical necessity, lack of clinical documentation, or a physician not participating with a plan. This is why "patient access cannot work as a silo in reviewing claim denials," says Carol Triggs, MS, director of patient access at St. Joseph's Hospital Health Center in Syracuse, NY. -
Get admin claims denials down to near zero
To reduce administrative claims denials, Virtua Healthcare System in Marlton, NJ, did two Six Sigma projects. "Our major mission for the first project was to identify root causes that resulted in administrative denials at all campuses and all registration types," says Diane E. Mastalski, CHAA, CHAM, director of patient access. -
Got a complaint? Use it to your advantage
Next time you get a complaint, don't let it ruin your day. Instead, find a way to make a customer's dissatisfaction work to your advantage. -
Don't hesitate to set high bar with staff goal-setting
"The goal for our staff is to reach at least a 90% monthly accuracy rating for preadmits, activations, and discharges," says Bailey Holloway, admitting evening coordinator at Maine Medical Center in Portland. -
Staff work up to par? Keep them informed
Were departmental goals achieved or exceeded? If so, employees will feel a sense of accomplishment for a job well done, says Joy Wright, a patient registration supervisor at Lodi (OH) Community Hospital. -
Ensure updates with peer-to-peer training
Some patient access leaders are realizing that exemplary staff members can be a major resource for training and education. This could be because staff are more comfortable learning from their colleagues, or because the department is being charged to do "more with less" and more formal training resources are cut. Either way, it can be a successful strategy. -
Challenge registrars to get accurate info
Will a completed registration be problem-free or result in a claims denial? The buck stops with the registrar. -
Is your policy doing enough to improve QA?
Consider the old adage, "garbage in, is garbage out." "This truly has a distinct meaning where upfront errors are concerned," says Jackie Mitchler, a revenue cycle analyst in the patient business services department at Affinity Health System in Menasha, WI. -
Get a better fit for your new access employee
Patient access jobs are challenging to fill for a variety of reasons. One is the need to recruit employees that are quick learners and flexible.