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Connecting the Dots: Patient Access to Billing

Connecting the Dots: Patient Access to Billing. Katie Johnson, MMC Director of Registration Bailey Holloway, MMC Admitting Manager. Relationship of Access & Billing Maintain & Enhance Input Connecting the Dots. Overview. Relationship of Access & Billing. Maintain & Enhance Input.

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Connecting the Dots: Patient Access to Billing

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  1. Connecting the Dots:Patient Access to Billing Katie Johnson, MMC Director of RegistrationBailey Holloway, MMC Admitting Manager

  2. Relationship of Access & Billing • Maintain & Enhance Input • Connecting the Dots Overview

  3. Relationship of Access & Billing

  4. Maintain & Enhance Input • Educate on purpose of each data element collected. • Communicate the importance & impact of completeness, accuracy, and timeliness. • Provide Feedback & Accountability:

  5. Today’s Patient Access Associate • Collect and verify 50 plus critical data elements that are required for various reasons including; patient care, revenue/reimbursement, meaningful use, and CMS requirements • Utilize multiple systems & applications that sometimes never interface • Collect basic clinical data • Interpret multiple, complex and ever changing insurance contract requirements • Manage financial, emotional and physical state of patient and their family members • Impact on Accounts Receivable and Reimbursement Yesterday's Registrar • Data Entry Clerks • Patient Transport • Switchboard • Order Entry You must complete all of this accurately and efficiently while;Managing financial, emotional and physical state of patient and their family memberBalancing demands of clinical stakeholdersAnd all with a SMILE 

  6. Provide Feedback & Accountability • Ownership of Accounts • Quality Review Process: • Real Time Edits/Warnings built in system • Manual Audit: • PreReg/PreAdmit • Discharge • Denials Coordinator attends team meeting to report out on last month’s activity • Special Projects Rep attends team meeting to report out on last month’s activity for Registration related Claim Edits & DNBs

  7. Claim Edits & DNB’s Related to Registration: • # of accounts • Total $ • Trends • Process Improvement - Education to resolve/minimize • Denials Received per payor: • # of accounts • Total $ • Trends • Process Improvement - Education to resolve/minimize Reg Related Claim Edits & DNB’s Monthly Report Out Denials CoordinatorMonthly Report Out

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