Author Archive for Dom Nicastro
Dom Nicastro is a senior managing editor for HCPro, Inc.’s revenue cycle division. He manages the Patient Access Resource Center and develops training, management, and compliance products for the company’s editorial team in the areas of: • Revenue cycle • HIPAA • Corporate Compliance • Materials Management • Patient Access • Patient Financial Services. Dom is the former editor of the Gloucester Daily Times, where he led the paper to the New England News Association Newspaper of the Year in 2005 and a runner-up for the same award by the New England Press Association in 2007.
Raise for passing CHAM
I recently took and passed the CHAM exam. We are now in the process of deciding what type of raise I will receive for this certification. Do any of you have a $$ amount or percentage increase that employees will receive if they pass the CHAA or CHAM? My employees who have passed the CHAA currently receive a $1 per-hour increase.
Any help will be greatly appreciated.
Beth Hunley, CHAM
Jay County Hospital
Portland, IN
Patient Registration Manager
Front end meets back end
If you want to get on the same page with your patient financial services team, there is a noteworthy article in the October, 2008 edition of the newsletter, Patient Access Advisor.
The article will help you:
- Understand why all the information on both ends is important
- Understand why it is not always possible to get the information
- Work together for solutions so that by the time a claim reaches patient financial services, it is ready to bill
- Understand what each denial is, why it is happening, and have a stake in cleaning up processes so that denials are reduced and, as possible, eliminated
Editor's note: The preceding tips were provided by Sandra J. Wolfskill, FHFMA, president of Wolfskill & Associates, Inc., in Chardon, OH.
Your revenue cycle in four years — better or worse?
President Barack Obama got a do-over at this week’s inauguration. Obama took the oath of office a second time on Wednesday because Chief Justice John Roberts deviated from the language in the Constitution the first time. Obama repeated the mistake, forcing a redo.
It got me thinking – why won’t CMS let revenue cycle managers do a “redo” on a bad claim and end it there? Wouldn’t it be nice if your Recovery Audit Contractor simply said, “This was wrong. Do it over. No monetary penalties.”
That won’t happen anytime soon – especially with Medicare’s Trust Fund predicted to go bankrupt by 2016. Just how will this new administration affect healthcare providers and their bottom line? I don’t have the answer.
Maybe you do. At the end of Obama’s term, where do you think your facility will be? Better off or not?
Obama promises quality; Dunn Memorial already delivers
Barack Obama today in his inaugural speech talked about the need for better healthcare quality and lower costs. Dunn Memorial Hospital’s patient access team certainly delivers quality with its Medicare Secondary Payer (MSP) form policies.
The Bedford, IN, facility last year scored a 100% compliance when auditors visited the facility.
To see how, read the story in our Patient Access Advisor newsletter.
Our new patient access Web site
Welcome to the new and improved Patient Access Resource Center. We kept you, the patient access manager, in mind and changed to a blog format.
Why?
We want to make this more interactive and essentially turn the Web site over to you. You now have the forum to comment on the latest news, tips, and tools that make you a better manager and your facility’s revenue cycle better for it.
I know your challenges. I spoke to many of you at the NAHAM annual conference in Dallas in May. You told me your needs are evolving. You told me in our annual salary survey that you have more responsibilities than ever. You talked about the need to get more on the same page with patient financial services. You told me getting registrars to understand the lifespan of an error remains a challenge.
I like to think of this new site as landing space for those concerns. Only now, not only do you get management and training tools, newsletter stories, and the latest news, you can comment on them and share feedback with your colleagues.
The bottom line for your facility’s revenue cycle?
You’re only as good as your front end, and now’s the time to start getting better.
Let’s start today – who wants to go first?
– Dom Nicastro
Senior managing editor
Patient Access Resource Center
Winner in patient access
The Patient Access Resource Center received entries for patient access staff members who go above and beyond for their departments last year. Here is a snapshot look at one of the winners:
Leona Brown
Title: Insurance verification specialist
Location: University of Virginia Health System in Charlottesville, VA
Years at facility: In patient access since 1990, and another department, Health Services Foundation, prior to that for many years
About Leona: “She has been the consistent employee that works tirelessly on difficult worker’s comp issues and claims to ensure that the detail is captured correctly for the patient and the medical center,” says her manager, Debra Rappold, manager, patient access, University of Virginia Health System. “She has mentored many new hires, coached and trained on various forms of insurance and the proper system application.”
Download these Revenue Cycle Institute white papers
The Revenue Cycle Institute announces new and updated white papers available for download. In addition to a new white paper on physician queries by Shannon McCall RHIA, CCS, CCS-P, CPC-I, director of coding and Health Information Management for HCPro, Inc., you will find an updated version of the whitepapers on the RAC demonstration project and the new ABN by Kimberly Anderwood Hoy, JD, CPC, director of Medicare and Compliance at HCPro, Inc., on the Revenue Cycle Institute Web site (www.revenuecycleinstitute.com).
National health spending growth at slowest pace since 1999
Americans spent only 0.2% more on healthcare in 2006 than they did the year before, triggering the slowest growth grate since 1999. The average American spends $7,421 on healthcare, according to a report by CMS.
“This is another reminder that the cost of healthcare continues to be a real and pressing concern facing the American public and the federal government,” said CMS Acting Administrator Kerry Weems in a statement. “This report – like the reports issued last year on the financial status of Medicare and Medicaid – is a stark reminder that we must redouble our ongoing efforts to reform the delivery of healthcare services in this country to bring about the goal of affordable, high quality health for all Americans.”
Delivering the Advanced Directive form
Advance Directive forms, to be completed by patients in case they are unable to make medical decisions for themselves, most often are presented by patient access staff members.
But any lack of communication among access, nursing, and case management staff members can lead to unnecessary confusion and headaches during compliance checks. Mandatory requirements from CMS, including the Fair Patient Billing Act, are on the minds of access managers lately. The goal is to comply and present Advance Directive forms in the most patient-friendly, transparent way.
Here are two tips from one patient access manager:
Just ask. The responsibility lies with patient access staff members to ask whether patients have or need a form. "My staff are informed during training on how to ask," says Vonda DeLorenzo, patient registration supervisor at Central Michigan Community Hospital in Mt. Pleasant. "For example: 'I see that you don't have an Advanced Directive for Healthcare. Would you like a copy?' "
Explain it like a “living will.” What if a patient asks about the form? DeLorenzo says they explain it as if it were a "living will," although Michigan doesn't recognize that term. "It is where you set up in advance your medical wishes should you become incapacitated and are unable to speak for yourself regarding your medical care," DeLorenzo adds. "You usually appoint an advocate who will act on your behalf, and [he or she has] to agree to act on your behalf. We try to keep it short and sweet and not spend too much time on it. Very few people are interested. You always get the one who wants to know if they are going to die today."
Crisis in the ER
Just how is the country’s emergency-room crisis affecting your patient access department? Surely, there are long waits and angry patients.
Recent national reports highlight the need for hospitals to improve their situations in the ER. We found one editorial from the Tampa Tribune that offers some ideas for improving the crisis.