Service quality and customer satisfaction related to Insurance industrykdore
Early researchers focused mostly on Banking, healthcare, retail, education etc
What is the existing situation of Service Quality in Sri Lankan Life Insurance Industry?
Does Service Quality affect on Customer Satisfaction in Life Insurance Industry?
What are the most important Services Quality dimensions which affect on Customer Satisfaction in Life Insurance Industry?
The aim of this presentation is to help Digital Marketing managers to implement an efficient e-marketing strategy in the particular and constrained environment of the pharmaceutical industry. This presentation can also be a good opportunity for Operational Marketing professionals jammed with the traditional 4p to realise that implementing a 360° marketing strategy is not only aligning Web and Marketing (or vice versa).
I took the opportunity of the success of my previous release to enhance and complete some slides in this V2.0. You will discover how a Biopharmaceutical company (Celgene) has taken a good start after my advises in 2010 and how they have implemented an e-marketing strategy with the evolution of their Internet portals and their connections to medical portals.
It seems to me that you can significantly improve your knowledge of e-marketing tactics with free tools in order to audit and monitor your consumer’s behaviours in the digital space by reading my other presentation: Digital Marketing Management.
Optimize Medical Representatives Visits using My Sales DialerAnjul Katare
Pharmaceutical Industry relies heavily on Medical Representatives (MR) for feedback, sale and constant touch with doctors and hospitals. This presentation demonstrates how My Sales Sales Dialer solution can optimize MRs work with remote management and tracking of agents.
Service quality and customer satisfaction related to Insurance industrykdore
Early researchers focused mostly on Banking, healthcare, retail, education etc
What is the existing situation of Service Quality in Sri Lankan Life Insurance Industry?
Does Service Quality affect on Customer Satisfaction in Life Insurance Industry?
What are the most important Services Quality dimensions which affect on Customer Satisfaction in Life Insurance Industry?
The aim of this presentation is to help Digital Marketing managers to implement an efficient e-marketing strategy in the particular and constrained environment of the pharmaceutical industry. This presentation can also be a good opportunity for Operational Marketing professionals jammed with the traditional 4p to realise that implementing a 360° marketing strategy is not only aligning Web and Marketing (or vice versa).
I took the opportunity of the success of my previous release to enhance and complete some slides in this V2.0. You will discover how a Biopharmaceutical company (Celgene) has taken a good start after my advises in 2010 and how they have implemented an e-marketing strategy with the evolution of their Internet portals and their connections to medical portals.
It seems to me that you can significantly improve your knowledge of e-marketing tactics with free tools in order to audit and monitor your consumer’s behaviours in the digital space by reading my other presentation: Digital Marketing Management.
Optimize Medical Representatives Visits using My Sales DialerAnjul Katare
Pharmaceutical Industry relies heavily on Medical Representatives (MR) for feedback, sale and constant touch with doctors and hospitals. This presentation demonstrates how My Sales Sales Dialer solution can optimize MRs work with remote management and tracking of agents.
Readmission rates remain high and unchanging. Why not rethink the problem. What if readmission rates could decrease by 20-30% by using an interactive discharge portal that allowed the discharged patient to enter data that would be reviewed by their provider.
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Readmission rates remain high and unchanging. Why not rethink the problem. What if readmission rates could decrease by 20-30% by using an interactive discharge portal that allowed the discharged patient to enter data that would be reviewed by their provider.
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The Impact of Patient Eligibility Verification on the Revenue Cycle.pdftevixMD
Patient eligibility verification is critical for a provider to maintain a healthy revenue cycle management (RCM) process. This step ensures that patients are eligible for the services provide, that the correct insurance information is used for billing for these services and the patient owed amount is defined.
Current Trends in Data Protection for Integrated Health, Centralized Peer Rev...PYA, P.C.
A webinar hosted by PYA and the Alliance for Quality Improvement (AQIPS) explored “Current Trends in Data Protection for Integrated Health, Centralized Peer Review Systems, and Other Innovative Programs.” PYA Principal Martie Ross participated in the webinar, which focused on how patient safety organization (PSO) protections can bring value to accountable care organizations and other integrated health systems.
In addition, the webinar provided instruction for using:
Patient Safety and Quality Improvement Act (PSQIA) protections in Medicare Shared Savings Programs, centralized peer review programs, and other collaboratives.
PSQIA protections for new types of clinical analysis, clinical quality reports, and performance tools that contain information that may not be protected under existing state peer review privilege or are shared among an integrated network.
Strategies To Improve Authorization For Revenue Cycle Management.pdfCosentus
Healthcare is a very important sector for the world. While it takes care of patient health, there are numerous aspects involved to run a healthcare organization or provider. One of the important aspects is finance, which helps the healthcare organization get the right remuneration and help it function smoothly so that it is able to provide the best healthcare services to the patients. One of the important parts of the finance aspect of a healthcare organization is revenue cycle management. For more visit pdf
CMS Core Measures Compliance: Best Practices for Data Collection, Analysis and Reporting
For many hospitals, the primary challenge with the core measure program is not achieving quality standards, but complying with the complex, time-consuming reporting process and staying current with constantly changing regulations.
As the effects of reform continue to implement changes to our nation’s health care structure, providers find themselves forced to act quickly amidst the resultant chaos. Nowhere is the confusion more apparent than when it comes to issues of compliance.
Contact Craig Garner for more information (craig (at) craiggarner (dot) com) or visit
http://craiggarner.com/compliance/.
Hidden Risk Area: Grievances- Are you Prepared for a Survey?PYA, P.C.
PYA Consulting Manager Susan Thomas co-presented with Sheila Limmroth of DCH Health System on “Hidden Risk Area: Patient Grievances–Are You Prepared for a Survey?” Their presentation focused on the following objectives:
-Define CMS expectations for a patient grievance process and how to use the guidance as a compliance work plan auditing tool.
-Discuss what state auditors review when they come onsite to assess your patient grievance process.
-Consider the role of compliance in the patient grievance process.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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3. Introduction
Patient Access Associates perform a diverse and complex range of tasks
during the registration process:
♦Data Collection
♦Insurance, Benefit Verification
♦Identification of Pt. Financial Liability, POS Collections
♦Securing required signatures
♦Acquisition of Referrals and Pre Certification
Embedded within the daily functions of an Access Associate are laws and
regulations applicable to their day-to-day job responsibilities.
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4. Today’s Discussion
♦ Identify violations that could lead to legal liability for the organization
and employee.
♦ Provide an understanding of the laws and regulations that impact Patient
Access Services.
♦ Learn techniques to incorporate a full realm of compliance training into
existing education plans.
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5. HIPAA Enforcement Examples
♦ Following investigation by the U.S. Dept. of Health and Human Services,
office for Civil Rights, the University of California at LA settles potential
violation of HIPAA for $865,000.
– Complaint alleged that two UCLAH employees looked at electronic
health records repeatedly without permission. Upon further
investigation, it was reported between 2005 -2008 numerous
employees looked at the EMR of patients without valid reason.
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6. HIPAA Enforcement Examples
♦ In 2009, Mass General lost PHI on over 192 patients – consisting of
patient schedules with names, MRN’s billing information, diagnoses,
procedures.
– An employee, while commuting, left the documentation on a subway
train. The documents were never found.
– $1M settlement
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7. Penalty and Action Plan
♦ Covered entities are responsible for actions of their employees.
♦ Penalties in the amount of $1.8M were incurred between the two
facilities.
♦ Corrective action plan established.
– Privacy and Security Policies and Procedures
– Regular and robust training
– Independent monitor to assess compliance
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8. Recovery Audit Contractor
♦ Three year demonstration – pilot (2005 through 2008)
– Identified $1.03 billion of improper Medicare payments
– $900 million in overpayments returned to Medicare Trust Fund
♦ 40 percent of overpayments due to medically unnecessary services (65
percent for services provided in an inappropriate setting)
♦ 8 percent due to insufficient documentation
♦ 35 percent connected to incorrect coding
♦ 17 percent – other category
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9. RAC Exposure
(*Evaluation of the 3-year demonstration)
Improper payments due to:
♦ Medically Unnecessary Services
♦ Services provided in an inappropriate setting
♦ Incorrect coding
♦ Improper documentation
♦ Other
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10. Patient Access Link
♦ Medical Necessity – Critical function in all access areas to:
– Prevent improper Medicare payments.
– Ensure provider can pursue payment from beneficiaries.
♦ Advance Beneficiary Notice (ABN) – Failure to issue an ABN can lead
to financial losses to an organization due to inability to bill for services
denied by Medicare as medically unnecessary.
♦ Medicare Secondary Payer Questionnaire (MSPQ)– Since 1980, the MSP
provisions have protected Medicare funds by ensuring that Medicare does
not pay for services and items that certain health insurance or coverage
has primary responsibilities for paying.
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11. Patient Access Link
♦ Physician Order Documentation – Denials when medical records failed to
have a clear admission order.
– Level-of-care orders documented
– Inadequate or incomplete admission orders
– Presence of an order on elective surgeries
– Physician education
– Standard Order Sets with clear delineation to admit to inpatient or
place in observation
– Identification of Inpatient Only Procedures
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12. Risk of Non Compliance
♦ RAC Exposure
♦ HIPAA Penalties
♦ Quality and Safety
♦ Customer Satisfaction
♦ Financial Liability
♦ Healthcare Fraud
♦ Loss of integrity and credibility
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13. Impact
♦ Privacy Violations – misuse of information
– Failure to comply with requirements and standards – not more than
$100 for each violation not to exceed $25,000
– Criminal penalties up to $50,000, $100,000 and $250,000 with
imprisonment up to 10 years
♦ Security Breach Notification and Penalties
– Notify patients
– If breach affects over 500 patients, notify DHHS
– Notify local media
– Results: Damage to the organizations reputation, Financial losses,
Fraud, Fines, and Personal Liability
♦ Returned overpayments to Medicare Trust Fund
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14. Patient Access Leadership Responsibilities
Patient Access is at the forefront and recognized as a vital component of the
Revenue Cycle and strongly influences the financial integrity of the
organization.
Essential to:
♦Engage in robust recruitment and retention strategies.
♦Develop a comprehensive education and training plan.
♦Put in place proper resources to ensure compliance.
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16. Training Techniques
Student Centered – Focus on the Trainee
Motivation – Build motivation activities
Activation – Give trainee opportunity for active participation
Reinforcement – Learner demonstrates a means of reinforcing newly
learned skill
Transfer – Trainer checks throughout program to ensure trainee has an
understanding of skill
Environment – Comfortable and suitable for learning
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17. Training Plan . . . Methodology
♦ Utilize a combination of techniques.
– Classroom training
– Preceptor
– On-the-job training
♦ Engage a subject matter expert as the dedicated trainer.
♦ Provide ongoing feedback, encouragement, and validation.
♦ Monitor, track, and measure competency.
♦ Provide training that incorporates:
– Demonstration
– Hands On Experience
– Policy and Procedure Review
♦ E Learn
♦ Training Modules
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18. Patient Access Orientation Training Plan
Week 1
Monday Tuesday Wednesday Thursday Friday
Dept.
Orientation
Patient Access
Overview –
Scope of
Responsibility
Data Collection
– Patient
Interviews
Insurance
Training
Compliance
and
Regulatory
Agencies
System
Training
Service
Excellence
Scripting Financial
Responsibility
• Completion of Healthcare System mandatory training modules
• Review of Associated Policies and Procedures
• Practical Application in ‘test’ system
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19. Patient Access New Orientation Training Plan
Week 2
Monday Tuesday Wednesday Thursday Friday
Physician
Order
Documentation
Outpatient
Registration
Inpatient
Registration
Emergency
Dept.
Registration
Scheduling,
Pre Encounter
Workflow,
Check In
• Review of Associated Policies and Procedures
• Practical Application in ‘test’ system
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20. Compliance
Compliance training is a critical component of an Access Department’s
training and education plan.
Educational goals should ensure the Access Associate:
♦Possesses a complete understanding of the laws and impact within Patient
Access.
♦Complies with policies and procedures.
♦Possesses knowledge and understanding of Medicare Compliance,
Regulatory Agencies governing compliance and healthcare laws.
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21. Essential Documentation for an Effective Training
Plan
♦ Outline
♦ Defined Objectives
♦ Content
♦ Method of Delivery
♦ Method of Evaluation
♦ Measurement of Competency
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22. Sample Compliance Training Module
Topic: Medical Necessity and ABN Compliance
Objective: At the completion of this program, the trainee will possess the
skills to perform medical necessity checks on all Medicare beneficiaries
rendering outpatient procedures and be compliant when issuing an ABN.
Content:
Medical Necessity Software Demo
Policy and Procedure
Method of Delivery:
Instructor led discussion, demo, and policy review
Self Learn Training Module with post test
Practical application utilizing sample physician orders
Method of Evaluation:
Post Test Competency
Direct Observation
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23. Effective Compliance Program
♦ Establish compliance standard, procedures and policies.
♦ Assign oversight responsibility for compliance to an individual high in
the organization’s structure.
♦ Conduct effective training and educational programs (communications of
standards).
♦ Perform internal audits and continued monitoring to detect
noncompliance and improve quality.
♦ Develop effective lines of communication for reporting violations and
clarifying policies.
♦ Enforce standard well-publicized discipline guidelines and procedures.
♦ Respond appropriately and immediately to detected offenses in order to
prevent further offense through corrective action.
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24. Key Ingredients to Compliance Training
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♦ Medicare Compliance
– Medical Necessity, Advance Beneficiary Notice (ABN)
– Important Message from Medicare
– Medicare Secondary Payer Questionnaire (MSPQ)
♦ The Joint Commission
– Patient Identification
– Patient Rights
♦ Laws
– Health Information Portability and Accountability Act 1996 (HIPAA)
– Health Information Technology for Economic and Clinical Health Act 2009
(HITECH)
– Red Flags Rules 2007
– Patient Self Determination Act 1991 (PSDA)
– Emergency Medical Treatment and Labor Act (EMTALA)Brought to you by
25. Regulatory Agencies
CMS: The Center for Medicare Services issues Regulations for Hospitals and
Conditions of Participation (COP). Every hospital accepting payment for
Medicare and Medicaid patients –including Joint Commission accredited
hospitals must comply with these conditions.
TJC: The Joint Commission provides evaluation and accreditation services for
multiple healthcare organizations such as general, psychiatric, children’s
rehabilitation, and critical access hospitals. TJC standards address the
organization’s level of performance in key functions such as patient rights, patient
treatment and infection control, and on its ability to provide safe, high quality
care. Joint Commission sets an important standard for hospital compliance
under the premise that if an organization does the right things and does them well,
there is a strong likelihood patients will experience good outcomes.
OIG: Office of Inspector General is the federal government’s Department of Health
and Human Services publishes compliance program guidance for multiple
sectors of healthcare and billing companies.
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26. Patient Access
Day-to-Day Responsibilities
When: During Registration, Outpatient, Emergency Department, Central
Scheduling, Financial Counseling, Admitting, Check-In
– Ensure positive identification of patients prior to the onset of registration
– Address the communication needs of each patient
– Meets the spiritual needs of patients
– Secure signatures Consent for Treatment, Assignment of Benefits, and Release of
Information
– Perform Medical Necessity, ABN
– Complete Medicare Secondary Payer Questionnaire
– Comply with EMTALA
– Distribute Patient Right to Privacy brochure
– Ensure Privacy and Security
– Be respectful of the patient’s option to ‘opt out’ of hospital directory
– Distribute Important Message from Medicare
– Address Advance Directive
– Ascertain Release of Information privileges
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27. HIPAA
The law known as “HIPAA” stands for the Health Insurance Portability and
Accountability Act of 1996. Congress, designed the Act to:
– Provide consumers with greater access to health care insurance.
– Protect the privacy of health care data.
– Promote more standardization and efficiency in the health care
industry.
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28. Patient Access Responsibilities
Privacy and Security
Ensure Privacy:
♦ Do not disclose or share your password with another employee.
♦ Log off computer when walking away from workstation.
♦ Avoid work related conversations in hallways or elevators.
♦ Update, test and maintain correct fax numbers.
♦ Know your hospital’s policies for leaving messages on answering
machines.
♦ Do not post patient information around your workstation.
♦ Dispose paper information in closed receptacles for shredding.
♦ Do not use your password to look up information on family members or
friends.
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29. HITECH
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The Health Information Technology for Economic and Clinical Health Act (HITECH
or "The Act") is part of the American Recovery and Reinvestment Act of 2009
(ARRA). ARRA contains incentives related to health care information technology in
general (e.g. creation of a national health care infrastructure) and contains specific
incentives designed to accelerate the adoption of electronic health record (EHR)
systems among providers.
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30. HITECH
HITECH also widens the scope of privacy and security protections available under
HIPAA; it increases the potential legal liability for non-compliance; and it provides
for more enforcement.
♦Right to Restrict enforced in 2010: Requires the covered entity to agree on
restriction of disclosure to a health plan if: The disclosure is for the purposes of
carrying out payment or healthcare operations and is not otherwise required by law;
and, The Protected Health Information (PHI) pertains solely to a health care item or
service for which the individual, or person on behalf of the individual other than the
health plan, has paid the covered entity in full.
*Patient Access Considerations: Insured Self Pay procedure
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31. EMTALA
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Under EMTALA, patients are to be “triaged” by a “clinician” to determine
severity of illness and degree of emergency prior to being asked about
insurance or method of payment.
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32. EMTALA
Three primary requirements on Medicare participating hospitals:
♦ The hospital must provide an appropriate medical screening exam (MSE).
♦ The hospital must treat and stabilize the emergency medical condition, or transfer.
♦ A hospital must not transfer an individual with an emergency medical condition
that has not been stabilized.
Regulations were amended in 2003 to specifically permit reasonable registration
procedures, including inquiries about insurance, before the medical screening
examination is done, again as long as those inquiries do not delay the
examination. A request for payment, however, may not be made at that time.
Patient Access Responsibilities:
♦ Know your hospital bylaws to identify ‘who’ can perform the MSE.
♦ Know triggers that communicate completion of MSE.
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33. 33
The Red Flags Rule requires many businesses and organizations to
implement a written Identity Theft Prevention Program designed to detect
the warning signs — or "red flags" — of identity theft in their day-to-day
operations. By identifying red flags in advance, businesses will be better
equipped to spot suspicious patterns that may arise -- and take steps to
prevent a red flag from escalating into a costly episode of identity theft.
RED FLAGS REGULATION
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34. Red Flags Regulation
Patient Access Responsibilities:
♦ Comply with patient identification policies.
♦ Be alert to suspicious, altered documents.
♦ Be alert to suspicious PHI, such as date of birth and photo identification
not consistent with the appearance of the patient.
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35. Patient Self Determination Act
Advance Directive means a written instruction, such as a living will or
durable power of attorney for health care, relating to the provision of health
care when the individual is incapacitated.
Organization’s Responsibility:
♦Provide written information regarding Advance Directives.
♦Document in Medical Record.
♦Educate patients, employees and community.
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36. Policies and Procedures
♦ Medical Necessity ABN
♦ EMTALA
♦ Medicare Secondary Payer
Questionnaire
♦ Patient Identification
♦ Emergency Department
Registration
♦ Orders for Outpatient Testing
♦ Advance Directive
♦ Registration of Family and
Friends
♦ Patient Rights and
Responsibilities
Related
♦ Guarantor Policy
♦ Performance Management
♦ Performance Improvement Plan
♦ Registration Quality Assurance
♦ Insured Self Pay Policy
♦ Patient Search, Name Standard
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37. Competency
Competency:
♦ Quality of being adequately or well qualified.
♦ Ability of an individual to perform a job properly.
♦ Set of defined behaviors that provide a structured guide enabling the
identification, evaluation and development of the behaviors in individual
employees.
♦ Combination of knowledge, skills, and behavior used to improve
performance.
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39. Performance Measurement
♦ Demonstration of Competency
♦ Ongoing Evaluation
– QA Monitoring
– MSP Audits
– Medical Necessity Compliance – Vendor Reports
– ‘Rounding’ with Reason
♦ Performance Management
– Behavioral Based
– Addresses Confidentiality and Security
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40. Method of Evaluation
♦ Pre- and Post- Test
♦ Return Demo
♦ Direct Observation
♦ Verbal Affirmation – Sign Off
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41. Employee Responsibilities
♦ Timely completion of mandatory training and education modules.
♦ Perform Medical Necessity check for outpatient procedures every time.
♦ Issue ABN when indicated.
♦ Accurate and complete documentation on MSPQ.
♦ Understand the importance of completion of MSPQ.
♦ Collaboration with Case Managers and other clinicians to ensure level of
care orders are in place.
♦ Consistent review of outpatient orders and appropriate follow up for
incomplete, illegible orders.
♦ Utilize solid interview techniques, adapt scripting.
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42. Individual and Department
Key Performance Indicators
Individual KPI
1. MSPQ audit
2. MED Necessity ABN audit
3. Documentation Audits
a. Consents
b. Place of Service Order
Department KPI
1. MSPQ audit
2. ABN Audit
3. Technical Denials
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43. Performance Management
Key Behaviors to ensure compliance:
♦ Adheres to the Health System’s Code of Conduct.
♦ Remains up to date and compliant with all Federal, State and Local laws,
Joint Commission standards or regulatory requirements which apply to
assigned area of responsibility.
♦ Ensures confidentiality of all customers/patients/residents information
and that information is only available to those who have a business
reason to know.
♦ Accepts responsibility for one’s actions and decisions.
♦ Builds trust and maintains consistency through words and actions.
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44. Improvement Needed
Behaviors
♦ Fails to follow laws, regulations or Health System policies consistently.
♦ Demonstrated by:
– Sub par auditing results
– Less that 100% MSP completion
– Failure to check Medical Necessity or issue an ABN 100% of time
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45. Access Leadership Responsibilities
♦ Develop policies.
♦ Communicate, Communicate, Communicate!
– Disseminate Information to staff.
♦ Measure Results.
– Improved Performance
– Reduction in Denials
♦ Audit.
– Round
– Individual and Department Performance
♦ Review results with staff, coach, and mentor.
♦ Report results to Sr. Leadership.
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46. Training Tool Kit
♦ Department Orientation Check List
♦ Training Module Documentation
♦ Competency Validation, Inventory, and Tracking Sheet
♦ Performance Management Evaluation Criteria
♦ Applicable Policies and Procedures
♦ Trainer Evaluation
♦ Sign In Sheet
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47. Benefits of an Effective Training Program
Employee
♦ Employee Satisfaction
♦ Professionalism
♦ Professional Development
Patient
♦ Patient Satisfaction
♦ Safety and Quality
♦ Positive Outcomes
♦ Dignity and respect
Organization
♦ Financial Security
– Reduced denials
– Less turnover
– No penalties
♦ Builds credibility
♦ Employer Satisfaction
♦ Improved Outcomes
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48. Unintentional Consequences – failure to comply
♦ Incorrect data validation – risk of privacy breach
Ask Don’t Tell Campaign
♦ Medical Necessity Checks on limited number of procedures
♦ Physician Selection errors - *Safety and Privacy
♦ Incorrect Guarantor listing
♦ Opt Out Vulnerability - *Safety
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49. Unintentional Consequences – failure to comply
♦ Incorrect data validation – risk of privacy breach
Ask Don’t Tell Campaign
♦ Medical Necessity Checks on limited number of procedures
♦ Physician Selection errors - *Safety and Privacy
♦ Incorrect Guarantor listing
♦ Opt Out Vulnerability - *Safety
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Editor's Notes
Valid reason: TPO only
Central PA $1.3M payment to Federal Government for improperly billing Medicare claims on patients who were not covered by Medicare
Loss of credibility of an organization
Clean Claim, Financial Liability and collection of self pay balances; Med Necessity Screening, MSP Completion,
Employee that is outgoing, energetic, motivated, well organized, strong communication skills, computer savvy.
Stand alone compliance training or incorporate training within each training module
Put plan in motion by applying practice to workflow for various access points
Highlighted areas addressed by all.
Future State: Meaningful Use, HER enhancements – patients are more involved with their care, can access diagnostics etc
Rounding: Observation of behavior, application of policies and procedures, assessment of resources.
Rounding (Employees want tools and resources necessary to do their job.
Assess compliance, Assess needs. Example: CPT and Diagnoses Codes