Patient Access » Training Tools

Training Tool: Medical necessity

Dom Nicastro — Mon, 01 Dec 2008 11:19:00 +0000

Editor’s note: This month’s training tool is provided by Khristine Anderson, training and data integrity specialist at Baptist Health South Florida, which includes seven hospitals in the Miami area. Baptist uses the following script for Medicare compliance and documenting medical necessity, which Medicare defines as services or items reasonable and necessary for the diagnosis or treatment of illness or injury. A provider who bills Medicare for services that Medicare deems not medically necessary can be prosecuted for fraud.This script is only a guide; departmental protocols should be followed for all circumstances not covered.

Training Tool: Scripting for the ABN

Dom Nicastro — Sat, 01 Nov 2008 09:38:00 +0000

Medicare considers a [name of test] to be frequency restricted. This means that Medicare may decide to deny payment for [name of test] if you have had it within the past [time period as indicated by First Comply software]. However, depending on your diagnosis and medications that you are on, this test may be covered more frequently than indicated by Medicare. This document is an advance beneficiary notice, which is also referred to as an ABN. This notice gives you the right to accept or decline the test based on the fact that it is a frequency-restricted test. The estimated cost of the test is [amount].

Training tool: Scripting tool

Dom Nicastro — Mon, 01 Sep 2008 10:23:00 +0000

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

Training tool: Registration assessment test

PARC Editor — Fri, 01 Aug 2008 16:41:00 +0000

Editor's note: The following are sample questions from the assessment test new patient access staff members at Boca Raton (FL) Community Hospital take after their four-day training program. The answers to each question are bolded.

Training tool: Q&A on HIPAA

PARC Editor — Sun, 01 Jun 2008 10:00:00 +0000

See the answers to important compliance questions for patient access teams regarding HIPAA.

Training tool: Completing the new ABN

PARC Editor — Thu, 01 May 2008 15:47:00 +0000

The following table, adapted from CMS' guidelines, outlines the details of filling in each blank on the new Advance Beneficiary Notice (ABN) of Noncoverage form, CMS R-131. The form is used by patient access staff members for Medicare patients.

Medicare secondary payer basics for registration staff

PARC Editor — Tue, 01 Apr 2008 09:25:00 +0000

True or false questions to help your staff achieve accuracy.

Training tool: Registration accuracy

PARC Editor — Sat, 01 Mar 2008 15:14:00 +0000

Training tool: Sample error percentage and volume form

Sample Advanced Directives form

PARC Editor — Fri, 01 Feb 2008 12:28:00 +0000

Learn how one facility uses this crucial form.

Training tool: Sample care management form

PARC Editor — Tue, 01 Jan 2008 15:09:00 +0000

Training tool: Sample care management form