Getting Ready for the New Year
Published November 3, 2011 | 
As Patient Access Reps we are required to keep up-to-date on all the changes and updates happening with various insurance plans that we deal with everyday. That includes doctor’s office personnel and hospital accounts receivable or financial accounting members. The easiest way is to have each of the major insurance websites bookmarked so that you can find the information for the coming year at your fingertips. Medicare has posted the changes for 2012 here: http://www.medicare.gov/cost/
Traditional Medicare Patient Costs beginning January 2012:
Part B Deductible (Doctor’s Office and Outpatient Hospital services)
Pay $140 per year and then 20% for most services
Hospital Inpatient Stay You pay:
$1,156 deductible per benefit period
$0 for the first 60 days of each benefit period
$289 per day for days 61-90 of each benefit period
$578 per “lifetime reserve day” after day 90 of each benefit period
(up to a maximum of 60 days over your lifetime)
Medicare Advantage Plans Example of Patient Costs:
Tricare Patient Costs Beginning October 1, 2011 to September 30, 2012:
(Go to the Tricare Website to Get the Complete Information)
These are just two of the most seen insurances in our area but they are good examples of what you will encounter with the rest of them. You will need to make a listing of your most popular insurances that your company encounters with their copays as the patients come after the first of the year. Good Luck and Happy Holidays in the coming months.
What Online Tools Do You Use
Published April 13, 2011 | What Online Tools Do You Use for your patient registrations? Utilizing whatever tools you can to ensure that you get accurate and timely information on ALL of your registrations is important for you keeping your job as well as making sure that your company stays in business. With the advent of the Red Flag Laws we are required to ensure that our patients are who they say they are. There is also the the ever increasing problem of patients seeking medical care just to get prescriptions for drugs who will tell you wrong information. This is especially true in Emergency Rooms across the country and with the EMTALA ruling we are required to treat patients regardless of their ability to pay. I am not advocating turning patients away or making them wait a long time for service but you should treat each registration of the patient as a new patient and confirm everything when they come in as well as ask for positive ID and their insurance cards. You cannot get a 100% accuracy rate but you can come close.
To that end we use a variety of online tools to ensure that the information we get from patients is current and accurate. To verify a drivers license you can try online verifications offered through your state’s DMV. To verify addresses you should try the postal service www.usps.com by putting in the address but not the zip code. They will tell you if the address is valid and deliverable. You should also try a reverse directory website for checking phone numbers and addresses. One of these that does not charge is www.whitepages.com. And you can use your county’s property appraiser’s website to verify an address and the owner.
Lastly, you should considered purchasing and using on online insurance verifications website such as Passport and Emdeon. Passport has the ability to verify social security numbers and have a wide variety of payers as well. They also have a payer address and claims information database that is fairly decent. WebMD or Emdeon is a very nice service as well. Now these are pay-for-use services and you will have to negotiate your own rates with them. You can also take advantage of the free services offered by each of the major insurance carriers. Availity is offered by our Medicare intermediary for free to Medicare and Blue Cross providers. Of Course, Tricare has an online eligibility verification system that is free to providers. United Healthcare offers their providers with online verification as well as the ability to view their insurance cards should a patient forget to bring one with them.
These are just some of the many tools available for Patient Access Reps or Insurance Clerks (whatever term your employers uses for Registrars) that can be used to help you do your jobs effectively and efficiently. It will also help your billing and collections department do their job in a timely manner. The name of the game is to ensure accuracy of information, entering information into your computer system correctly and make sure that the claims go to the right insurance as quickly as possible to get the money back.
Health Care Reform For Patient Access Reps
Published May 1, 2010 | Of course the most talked about subject in healthcare is the new Healthcare Plan that is now a law. As Medical Clerks we really need to understand the changes coming and to be able to help our patients understand some of their rights under the new plan. There are literally hundreds of different websites that have information on the changes that are taking place now and in the future. Which one you choose to read is really up to you. Read your employers information as well as some of the different medical associations websites for updates now and in the future. Be sure to bookmark the ones you find the most useful.
http://www.whitehouse.gov/issues/health-care
Here is an excerpt from their website:
“It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today. This helps 32 million Americans afford health care who do not get it today – and makes
coverage more affordable for many more. Under the plan, 95% of Americans will be insured.
It sets up a new competitive health insurance market giving millions of Americans the same choices of insurance that members of Congress will have. It brings greater accountability to health care by laying out commonsense rules of the road to keep premiums down and prevent insurance industry abuses and denial of
care.
It will end discrimination against Americans with pre-existing conditions. It puts our budget and economy on a more stable path by reducing the deficit by more than $100 billion over the next ten years – and more than $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.”
The second website we looked at is simply called the HealthReform.gov The information on the website is geared mostly towards patients and small business who are most affected by the changes. There is a pretty good FAQ section for both. It also has news sections for each state.
So give these two websites a try and read through the information. The more you know and understand about insurance the better able you will be to help your patients and your employer!
Future for Patient Access Reps
Published September 15, 2009 | We are constantly having to keep on our toes with information and education. With the Healthcare field projecting to have an average 18% increase in need over the next 5 years and more industries shutting down or not having any increase in jobs we who keep on time of the new trends within our area. After reading over several blogs and articles in newspapers and medical sites I have found a couple of things that have peak my interest.
The first of these are medical smart cards. It is a plastic card the size of a credit card that contains all of your patients medical records. The patient carries it around with them from medical center, to doctor to hospital and the medical personnel only has to slide or swipe it and all the information gets uploaded to the computer. Of course you will need compatible card readers and software to receive the records and update them. Some can even include the patient’s demographic and insurance information. Check out the following websites for more information: Project SwipeIT and smartcardalliance.org.
Doctors have access to medical reference apps on their iphones such as Taber’s Medical Dictionary, Davis’s Drug guide and STAT ICD-9 LITE and soon even patient records and updates on patients progress in the hospital on their blackberries. Medical Schools are beginning Google is gathering supporters within the insurance companies to provide patient data to Google’s electronic personal health record platform. The goal of which is to have the patient’s medical history accessable online for the patient to grant access to their medical providers.
And finally, my favorite, is virtual reality training. A hospital in Chicago commissioned a company called Linden Lab to create a virtual replica of their hospital and the surrounding area inside and out. The Second Life program allows the employees to practice Emergency drills in virtual real time. This game can be set for a variety of disasters and each employee can go online to practice drills and learn how to do them without interupting the hospital routine. This application can be used for a variety of different scenarios.
Cheers!