HCPro.com: Patient Access Advisor

Here's a resource for directors and managers of patient financial services (PFS) to help them capitalize on revenue opportunities and improve the bottom line; every issue is filled with training tools and resources including sample policies, forms, and worksheets to institute improvements in the department, reduce denied claims, improve front-end processes, and track government and private payer rules.

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September 2008 (Volume 5, Issue 9)	view entire issue

Now is the time to prepare for the RAC program
Editor's note: Coming in October, PAA begins a series of stories on the Medicare Secondary Payer (MSP) Questionnaire. Most of your peers in the revenue cycle are not fully prepared for the 2010 arrival of the Medicare Recovery Audit Contractor (RAC) program. HCPro's RAC Preparedness Survey polled patient access and patient financial services managers across the country in July about the nationwide program beginning January 1, 2010. Nearly 75% of survey respondents said they need more preparation for the arrival of RACs at their facilities.

Facts about recovery audit contractors
Prepare for the 2010 Recovery Audit Contractor (RAC) program rollout with these facts and figures provided by CMS and William Malm, ND, RN, practice director for revenue cycle management at HCPro, Inc., in Marblehead, MA: Getting started. The original RAC demonstration project, which ran from March 2005-March 2008, had two objectives: to detect and correct improper payments.

Make the most of your assessment
Editor's note: This article is the second in a two-part series. The article in the August PAA focused on areas to assess within your registration process. In the August PAA, I outlined some specific issues you should address in order to assess the quality and comprehensiveness of your registration process. This article will discuss various recommendations for addressing and resolving these issues. Although these recommendations have a proven track record, keep in mind that your priorities and solutions will vary based on many factors, including your specific flow, internal policies and procedures, and physical setup.

Copayments could be reduced under OPPS proposed rule
CMS' 2009 Outpatient Prospective Payment System (OPPS) proposed rule might lead to a reduction in the copayment amount for services at hospitals that have not met their quality measure reporting requirements. Hospitals reporting required outpatient quality measures in 2009 will receive a 2% inflation update. Hospitals not reporting these measures will not receive this update.

Solidify your ED copayment collection policy
The patient access team at Houston Medical Center in Warner Robins, GA, did not have the best luck collecting copayments in its ED. "Our copay collection process had never been super good," says Rhonda Carpenter, BSBA, CHAM, director of patient access at Houston Medical, a 279-bed facility that sees 600,000 patients per year. Carpenter says the clinical team didn't have a large enough role in the process.

Tip of the month: Create a managed care plan matrix
It is useful to have a contracted insurance matrix that patient access staff members can use as a reference guide to identify which plans have managed care requirements.

Keller named to PAA advisory board
Patient Access Advisor named Debra Keller, CHAA, to its advisory board in July. Keller, the admissions/registration director for the Grand Itasca Clinic and Hospital in Grand Rapids, MN, has more than 20 years of experience and manages 35 employees in the clinic's call center and registration and admissions offices.

Training tool: Scripting tool
Check out this scripting tool used by Houston Medical Center's patient access team in Warner Robins, GA, for collecting copayments in the ED.

This Month’s Form
Check out this form used by the patient access team at Houston Medical Center in Warner Robins, GA, to explain to patients the estimated costs associated with their care.

Other recently-published articles from Patient Access Advisor:

Training Tool: Medical necessity

This month’s form

This year’s patient access succes

Manual instructions issued for revised ABN form

This Month’s Form

Training Tool: Scripting for the ABN

Enhance your revenue cycle performance through effective communication

100% MSP compliance

Facts on Medicare’s Recovery Audit Contractor program

Get RAC ready

The big picture for your Recovery Audit Contractor team

This Month’s Form

Training Tool: Patient Access Scripting

Last quarter is a good time for a review

FAQs about the new ABN

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