This document provides a draft model for developing a Patient Access department at Four County Centers. It includes mission and vision statements, a description of services, and proposed key performance measures. Some of the priorities and goals outlined are improving the patient registration flow, ensuring HIPAA compliance, implementing financial counseling, transitioning paper processes to electronic formats, and achieving customer satisfaction, collection, and accuracy standards above 80%. Establishing a call center is also discussed to help schedule clients and free up front desk staff.
How to Earn Your 9% MIPS Incentive Despite 2020 ChallengesKareo
In this webinar, Sr. Training Specialist, Marina Verdara, will provide you with the information and tools you need to ensure that you or your billing clients’ practices avoid receiving monetary penalties related to MIPS.
Medical Billing Monitor LLC is one of the leading medical billing companies, based out of Los Angeles, California, started by a team of dedicated experienced experts in the medical billing industry, to provide quality medical billing services to medical practices and medical billing companies in the United States. The experts in our team started in the early 2000’s, and have grown to be one of the global leaders in the Industry.
We provide end-to-end medical billing services that help our clients in reducing the expenses and increasing the reimbursements. Our medical billing services include revenue cycle management, accounts receivable management, medical coding, outsourcing, indexing, medical records, insurance eligibility verification, and physician credentialing and data conversion. Moreover being HIPAA compliant medical billing company, we achieve accuracy, eliminating flaws and we have greater process control as well as efficiency.
In this live webinar, Valora outlines the three main stages of starting a medical practice:
1) Planning - creating a business plan, setting a budget and outlining your timeline
2) The Nuts and Bolts - finding a location, credentialing, administrative setup, and choosing the right technology for your needs
3) Opening - hiring staff and activating your marketing plans
How to Earn Your 9% MIPS Incentive Despite 2020 ChallengesKareo
In this webinar, Sr. Training Specialist, Marina Verdara, will provide you with the information and tools you need to ensure that you or your billing clients’ practices avoid receiving monetary penalties related to MIPS.
Medical Billing Monitor LLC is one of the leading medical billing companies, based out of Los Angeles, California, started by a team of dedicated experienced experts in the medical billing industry, to provide quality medical billing services to medical practices and medical billing companies in the United States. The experts in our team started in the early 2000’s, and have grown to be one of the global leaders in the Industry.
We provide end-to-end medical billing services that help our clients in reducing the expenses and increasing the reimbursements. Our medical billing services include revenue cycle management, accounts receivable management, medical coding, outsourcing, indexing, medical records, insurance eligibility verification, and physician credentialing and data conversion. Moreover being HIPAA compliant medical billing company, we achieve accuracy, eliminating flaws and we have greater process control as well as efficiency.
In this live webinar, Valora outlines the three main stages of starting a medical practice:
1) Planning - creating a business plan, setting a budget and outlining your timeline
2) The Nuts and Bolts - finding a location, credentialing, administrative setup, and choosing the right technology for your needs
3) Opening - hiring staff and activating your marketing plans
Collecting Patient Payments During COVID-19 and Beyond - a Blueprint for SuccessKareo
The impact of COVID-19 is substantial and the way healthcare providers practice medicine has changed, and it’s not going back. Make sure your business has the right blueprint for success so you can continue collecting patient payments while providing quality care to keep your patients healthy and your practice profitable.
Structuring Your Contracts for the Current ClimateKareo
Learn about the evolution of revenue cycle management and how to best structure your contracts now that patient responsibility is on the rise. Additionally, Aimee will walk through how to have tough conversations with clients when they are not being compliant.
Presented by Aimee Heckmann
How to Build a 5-Star Practice with a Patient-Centered ApproachKareo
Valora Gurganious, MBA, CHBC, Partner, Senior Management Consultant will discuss:
-The importance of an enhanced patient experience and how it affects all aspects of your business such as your collections rate and patient retention
-How adopting technology can help you see more patients daily without the administrative burden
-The areas of your current workflow that can be enhanced to build and maintain positive relationships with your patients
Key Findings from MD Ranger's 2018 Total Facility Benchmarks ReportMD Ranger, Inc.
Review key findings from our recently published 2018 Total Facility Benchmark Reports, as well as compare them to past years' reports to uncover trends in physician payments.
This presentation covers:
-How much hospitals spend on call coverage and medical directorships
-Facility-wide physician contracting trends
-How healthcare organizations use facility-wide benchmarks to drive better performance
-And more!
It is now time for physician practices to get revenue cycles in order to improve financial performance. The entire process is complex in nature and often results in errors that negatively affect an organization’s profit margin.
HIPAA & OIG Compliance for Medical Billing Company OwnersKareo
The success of your business relies on timely billing and accurate coding. Whether you’re managing the billing for one provider or 50, it’s a complex job that must meet a variety of regulations, making it easy for medical billing companies to be the target of false claims and fraudulent crimes. As healthcare fraud continues to be a growing issue in the industry, medical billers are increasingly being held liable for their role in the submission of fraudulent claims.
Executive Director of American Medical Billing Association, Cyndee Weston, CMRS, CMCS, CPC, will provide an in-depth analysis of what can be considered fraud when submitting medical claims, how the government is enforcing guidelines, and what you can do to help protect your business as well as your practices.
Bristol Healthcare Services is one of the leading onshore/offshore providers of medical billing & coding services. We provide end to end services helping our clients to reduce their cost and increase their revenues. Our experience ensures we deliver all our services with high accuracy, high productivity within assured turnaround time.
Our combination of stable resources, advanced technology and six sigma methodology has resulted in great success stories. Our certified resources deliver with high precision based on each client’s requirements. Our customer delivery team is driven by quality to ensure consistency, continuous improvement and customer satisfaction.
“Your search for dependable, committed partner in your process management ends here”.
Our end to end Medical Billing Services Include:
Benefits / Eligibility Verification
Medical Coding
Demographics Registration
Charge / Claim Entries
Cash / Payment Posting
Account Receivables Management
Effective dental billing services result in increased patient satisfaction, decreased billing errors, and improved cash flow. Dental clinics can find the secret to financial success and a long-term by placing a high priority on revenue cycle management.
10 Essential Tips for Streamlining Your Medical Billing Services.pdfmedquikhelathsolutio
For many medical professionals, the joy of caring for patients can be overshadowed by the complexities of medical billing. The process can feel overwhelming, riddled with potential errors and delays that hinder revenue collection. Fortunately, with the right strategies in place, you can significantly streamline your medical billing services, improve efficiency, and maximize revenue generation.
Collecting Patient Payments During COVID-19 and Beyond - a Blueprint for SuccessKareo
The impact of COVID-19 is substantial and the way healthcare providers practice medicine has changed, and it’s not going back. Make sure your business has the right blueprint for success so you can continue collecting patient payments while providing quality care to keep your patients healthy and your practice profitable.
Structuring Your Contracts for the Current ClimateKareo
Learn about the evolution of revenue cycle management and how to best structure your contracts now that patient responsibility is on the rise. Additionally, Aimee will walk through how to have tough conversations with clients when they are not being compliant.
Presented by Aimee Heckmann
How to Build a 5-Star Practice with a Patient-Centered ApproachKareo
Valora Gurganious, MBA, CHBC, Partner, Senior Management Consultant will discuss:
-The importance of an enhanced patient experience and how it affects all aspects of your business such as your collections rate and patient retention
-How adopting technology can help you see more patients daily without the administrative burden
-The areas of your current workflow that can be enhanced to build and maintain positive relationships with your patients
Key Findings from MD Ranger's 2018 Total Facility Benchmarks ReportMD Ranger, Inc.
Review key findings from our recently published 2018 Total Facility Benchmark Reports, as well as compare them to past years' reports to uncover trends in physician payments.
This presentation covers:
-How much hospitals spend on call coverage and medical directorships
-Facility-wide physician contracting trends
-How healthcare organizations use facility-wide benchmarks to drive better performance
-And more!
It is now time for physician practices to get revenue cycles in order to improve financial performance. The entire process is complex in nature and often results in errors that negatively affect an organization’s profit margin.
HIPAA & OIG Compliance for Medical Billing Company OwnersKareo
The success of your business relies on timely billing and accurate coding. Whether you’re managing the billing for one provider or 50, it’s a complex job that must meet a variety of regulations, making it easy for medical billing companies to be the target of false claims and fraudulent crimes. As healthcare fraud continues to be a growing issue in the industry, medical billers are increasingly being held liable for their role in the submission of fraudulent claims.
Executive Director of American Medical Billing Association, Cyndee Weston, CMRS, CMCS, CPC, will provide an in-depth analysis of what can be considered fraud when submitting medical claims, how the government is enforcing guidelines, and what you can do to help protect your business as well as your practices.
Bristol Healthcare Services is one of the leading onshore/offshore providers of medical billing & coding services. We provide end to end services helping our clients to reduce their cost and increase their revenues. Our experience ensures we deliver all our services with high accuracy, high productivity within assured turnaround time.
Our combination of stable resources, advanced technology and six sigma methodology has resulted in great success stories. Our certified resources deliver with high precision based on each client’s requirements. Our customer delivery team is driven by quality to ensure consistency, continuous improvement and customer satisfaction.
“Your search for dependable, committed partner in your process management ends here”.
Our end to end Medical Billing Services Include:
Benefits / Eligibility Verification
Medical Coding
Demographics Registration
Charge / Claim Entries
Cash / Payment Posting
Account Receivables Management
Effective dental billing services result in increased patient satisfaction, decreased billing errors, and improved cash flow. Dental clinics can find the secret to financial success and a long-term by placing a high priority on revenue cycle management.
10 Essential Tips for Streamlining Your Medical Billing Services.pdfmedquikhelathsolutio
For many medical professionals, the joy of caring for patients can be overshadowed by the complexities of medical billing. The process can feel overwhelming, riddled with potential errors and delays that hinder revenue collection. Fortunately, with the right strategies in place, you can significantly streamline your medical billing services, improve efficiency, and maximize revenue generation.
Hospital / Technology / Revenue / Business
This is the approach for success in terms of workflow, revenue, and technology effeciency in HIT (Healthcare Information Technology).
Top 10 Medical Billing KPIs That Show You Where You’re Losing MoneyKareo
If you can’t remember the last time you assessed the efficiency and performance of your medical practice billing, now is the time to do it. Of course, evaluating the entire patient-to-payment revenue process for inefficiencies and issues may be a daunting task for an independent practice. Kareo managed billing expert Marybeth Quesada walks you through some of the key signs that you’re not collecting the amount you should be for the services you provide.
Learning Objectives:
-Assess the performance of your medical billing process
-Cover essential KPIs including denials, rejections and days in A/R
-Review how to audit medical records for under-coding or over-coding
-Gauge the effectiveness of your patient statements process
Top 10 Medical Billing KPIs That Show Where Your Practice is Losing MoneyKareo
Kareo’s Billing Subject Matter Expert, Terri Joy, MBA, CPC, CGSC, COC, CPC-I, shares the 10 medical billing KPIs you need to know to prevent your practice from losing money.
Eight strategies to get paid - Revenue Cycle ManagementJames Muir
Join revenue cycle management expert Elizabeth Woodcock & James Muir to dissect the eight strategies for surviving and thriving in today’s turbulent reimbursement environment. This webinar will empower you with solutions to make your practice a top performer. In addition, attendees of this live webinar can quality for CEU credits.*
After this session, you’ll be able to:
Evaluate payer contracting opportunities and pitfalls
Determine contract management procedures to ensure appropriate payment
Implement effective methods of setting patient’s expectations for payment – before the visit
Apply time-of-service collections techniques
Develop denial prevention and management procedures
Assess technologies to support efficient revenue cycle management
Identify staffing needs for successful revenue cycle management
Differentiate the elements of reporting key performance indicators for revenue cycle management
Technology: Increase Revenue, Decrease Workload An AOA WebinarHealth iPASS
The growing chorus of patients with high deductible plans places a greater burden on medical providers to implement patient revenue cycle solutions that optimize net collection rates. Patients are now the largest payers in healthcare. Patient payment technology solutions have the unique ability to promote healthcare price transparency by educating and empowering healthcare consumerism with insurance eligibility information, cost-of-care estimates, co-pay and deductible amounts, and estimates of what balance may be owed post insurance claim adjudication. Learn more about how and why implementing a patient payment collection technology solution empowers, engages, educates, and delights patients through a convenient and intuitive patient check-in kiosk. Plus, learn more about the new “vitals” to track patient revenue cycle management to improve patient net collection rates in this webinar slide deck.
Navigating the Revenue Management Cycle in Healthcare.docxdoctorsbackoffice4
The revenue management cycle in healthcare encompasses the end-to-end process of managing financial interactions, from patient encounters to reimbursement. This cycle involves various stages, including patient registration, eligibility verification, charge capture, claims submission, payment posting, and accounts receivable management.
Streamlining Your Medical Practice for Profitability and SuccessConventus
Conventus webinar video providing key success strategies and tactics for improving productivity, profitability, and patient care. The one-hour video features host Susan Lieberman of Conventus and Stevie Davidson of Health Informatics Consulting.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase – a growing risk to the bottom line.
Accurate data mining is the best thing in medical billing services, MGSI providing and helping physicians and medical practices with Tops ideas to improve medical billing services.
https://www.mgsionline.com/medical-billing-and-collections.html
#MedicalBillingCollections
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Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
3. 3
Patient Access Services Department Mission
Statement
To serve the community by promoting patient support
and meeting the needs of our patients, visitors,
volunteers, and staff.
4. 4
Patient Access Services Department Vision
Patient Access Services strives for
excellence in quality, efficiency, and
customer service.
5. 5
Description of Service/Department
The primary purpose of this Service/Department is to:
• Complete accurate registration in compliance with all regulatory and Four County Counseling Centers
guidelines.
• Verify eligibility and Benefits for mental health insurance coverage, collecting co-insurance,
deductibles and co-pay amounts to improve front end revenue cycle operations.
• Provide financial counseling and payment assistance options for clients who are uninsured or
determined to be ineligible for government programs.
• Provide excellent customer service, adhering to Four County Counseling Center code of conduct and
industry best practices.
• Working in collaboration with clinical staff, insurances, regulatory agencies and support departments.
6. 6
Key Performance Measures and Service Line Best Practices
Registration Accuracy:
Quality of Registration Data
Demographics (bad addresses)
DOB
SSN#
Valid Phone Number
ID and Insurance card scanning
Duplicate records
Correct Program selected
Correct Provider selected
7. 7
Key Performance Measures and Service Line Best
Practices Cont’d:
Scheduling Accuracy
Accurate Provider Scheduling
Appropriate Provider Selected Based on Credentialing
Timely Notification of Upcoming Appointments
Special Needs Identified
Front End Revenue Cycle
Front End Billing
ABN/Medical Necessity
MSP/Medicare Secondary Payor
Co-Pays Collected
Medicaid Presumptive Eligibility Completed
8. 8
Key Performance Measures and Service Line Best
Practices Cont’d:
Billing/POS Collections For Clients Engaged in Key Programs
Identify Specific Program of Engagement For Correct POS Collection
Identify Recovery Works clients
Identify Department Child Services Clients
Vivitrol Clinic Clients
Determine Percentage of Job Performance
Financial Counseling
Identify Client In Need of Financial Counseling
Scripting for Financial Counseling
Financial Data Collection to Identify Clients
Scheduling Financial Counseling Appointments
Determine Percentage of Job Performance
9. 9
Key Performance Measures and Service Line Best
Practices Cont’d:
Patient Complaints
Customer Service Complaints
Timeliness In Client Complaint Resolution
Denials for No Authorizations
Reports No Authorization/Precertification
Report Out Insurance Denials when PAS Responsible for Securing Authorizations
Determine Percentage of Job Performance
10. 10
Key Performance Measures and Service Line Best
Practices Cont’d:
Development of Policies and Procedures
Review and Write Policies and Procedures
Policy Implementation
Employment Engagement/Education
Recognition
Face Time
Timely Employee Evaluations
Staff education
Survey Results
Client Surveys
Develop Surveys Through Survey Monkey
11. 11
Key Performance Measures and Service Line Best
Practices Cont’d:
“Best Practice” Community Mental Health:
Upfront Collections: Ability to know patient
liability prior to point of service.
Front Desk insurance entry, insurance verification.
Front Office Scanning: Documents imaging and
retrieval technology.
Front Office Signatures: Electronic signature pads
technology.
Eligibility Technology: Ability to batch eligibility of
Medicaid and Major Commercial Insurance.
Wait times – clients waiting to be checked in.
How does our performance currently compare:
Improve POS Collections, identify reports to show cash
collected vs cash to be collected.
Identify EMH system changes to improve data entry and
notifications.
Customer Service training.
Financial Counseling training/implementation
Obtain software for electronic signature.
Utilize batch eligibility systems.
Explore kiosks for check-in.
Establish sign-in for clients.
12. 12
Key Performance Measures and Service Line Best
Practices Cont’d:
Department’s current-state:
• Registration area client flow awkward,
not streamlines.
• No areas for financial counseling that is
HIPAA compliant
• Too much paper, not enough electronic
processes.
Transfer sheets
Pre-Auth sheets
In-take packets
• Re-design registration area.
• Identify area for financial counseling
• Transition paper processes to
electronic processes.
13. 13
Competitive Advantage Now and in the Future:
What processes, skills and services make our
department unique?
• Community Mental Health center in rural
areas.
• Ability to register clients at POS or via pre-
services.
What new/different processes, skills will be needed to
create competitive advantage and success in the next 1
to 2 years?
• To have all registrars credentialed as Certified
Healthcare Access Associates (CHAA), promoting
staff development and staff retention.
• Continue working on streamlining registration
process, promoting feedback to staff, implement
fully operations patient portal.
14. 14
Critical Success Factors/Priorities
Identify the critical success factors and priorities for
Patient Access Services including I.T. requirements
(such as training, software, devices, etc.)
• Improve POS collections
• Improve client registration flow
• Ensure HIPAA compliance
• Implement financial counseling
• Electronic processes
Developing Standard of Work
• Developing process flow
• Developing an education plan and individual
competencies.
• Staff development
• Automated Processes, integration of new
technology and support.
• Managers and Directors (CHAM certified or HFMA
Certification)
• Develop staff scripting for improved POS
collections
• Develop Policies and Procedures
• Conduct annual POS collections training
15. 15
Quality Standards
Goals:
Customer Satisfaction with the registration
process will be consistently> 80% per month.
POS collections >80%.
Account audits > 95% accuracy (<3% error).
Reminder Calls Completed 100%.
Client Financial Screening >98%.
How will goals/standards be measured:
Helpfulness of registration survey.
Daily/monthly cash actual collection.
Monthly audits of client accounts, correct information
obtained and entered.
Automated system.
Implement Financial Counseling.
16. 16
Quality Standards
Pre-Registration Rate >98%
Collection of balances >50%
Insurance Verification >98%
Implement Pre-Services service line.
Set payment plans at POS.
Implement automated systems to batch
verification.
17. 17
Will there be a need for a Call Center:
Call Center:
• Identify call volumes (incoming/outgoing).
• Determine outside calls vs internal calls.
• Staff needed to establish call center.
Benefits of a call center:
• Free up front desk staff
• More efficient scheduling for client and clinicians
• Allow staff to engage clients