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Patient Friendly Registration and Billing . Kim Tilley IS Specialist Citizens Memorial Healthcare November 8, 2006. Patient Friendly Project Overview. Insurance information on the CMH Website Insurance pre-authorization processes Patient Friendly Identification Cards Patient Pictures

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patient friendly registration and billing

Patient Friendly Registration and Billing

Kim Tilley

IS Specialist

Citizens Memorial Healthcare

November 8, 2006

patient friendly project overview
Patient Friendly Project Overview
  • Insurance information on the CMH Website
  • Insurance pre-authorization processes
  • Patient Friendly Identification Cards
  • Patient Pictures
  • Insurance verification
  • Co-pay opportunity to pay
  • Charges by documentation
  • Preliminary bill
  • Final bill w/in 3 days/5 days
  • Friendly Statements
  • Online Billing Portal
  • Clinical Patient Portal
  • Into the future: Self Check In
insurance pre authorization
Insurance Pre-Authorization
  • Assure that tests/treatments that require pre-authorization are pre-authorized
  • More and more companies are requiring pre-authorization for services
  • Pre-authorization should be completed by the scheduling site
  • Patient Access can run reports to verify that pre-certification is completed
  • Pre-authorization fields are reviewed at registration
patient friendly identification cards
Patient Friendly Identification Cards
  • Assures that the correct patient is identified quickly
  • Help patient feel that he or she has a personal identity with CMH
  • Does not expire!
  • Patient consents for treatment by using the card
express card how it works
Express Card: How it works
  • A unique patient identifier is embedded in the barcode of the card (E#EMR #)
  • To use, have cursor in patient field and scan the card with the barcode reader
  • The cards placed additional pressure on registration for an express registration process
initial rollout patient friendly cards
Initial Rollout (Patient Friendly Cards)
  • Ordered blank cards with the express card logo on the front
  • Purchased a Zebra card printer
  • Created NPR reports that took the list of scheduled patients and excluded patients with duplicate social security numbers
  • Created an NPR report that bar coded and printed statement on the back of the card
  • Cards and agreements given to patient at check-in for the scheduled appointment

Now, patient friendly cards are printed upon request at check-in

patient pictures
Patient Pictures

Patient Pictures can help protect our patients by...

  • Providing a visual indicator that assures the correct patient is selected
  • Personalizing the registration process
subsequent registrations
Subsequent Registrations

A. MPI

B. Display Picture Button

C. Display Routine

initial rollout patient pictures
Initial Rollout (Patient Pictures)
  • Purchased web cameras and placed them in all registration areas
  • Assigned a HealthStream (LMS) course to all patient access staff
  • Phased in the patient picture capture process by area
  • On-site support and training the day of LIVE for each area
universal printed consent
Universal Printed Consent
  • Consent can be printed at the end of each registration and includes the patient’s information
  • Valid for one year
  • Valid for both hospital and clinic services
initial rollout universal consent
Initial Rollout (Universal Consent)
  • Consulted with our attorney in order to determine the legality of one year universal consent that is valid in all CMH locations
  • Created/altered our ADM forms to include the patient information and the expiration date
  • Registration began checking the consent expiration date before asking the patient to sign a consent
insurance verification
Insurance Verification
  • Helps us to verify that we have the correct policy information on file
  • Identifies the status of a patient’s coverage, i.e. active or inactive
  • Allows us to verify that we are filing a claim to the correct plan
  • Can be completed real time while the patient is present or after the fact
opportunity to pay
Opportunity to Pay
  • Patients asked to pay a deposit on their account
  • Payment is entered and the patient is given a receipt
  • Every $ is a small account that doesn’t have to be collected later
charges by documentation
Charges by Documentation
  • Clinical modules have been designed to collect charges as a by product of patient care documentation
  • Decrease charge entry
  • Even avoid extra clicks
  • Match documentation to charges
  • 90% of charges by documentation
preliminary bill
Preliminary Bill
  • Goal to produce a preliminary bill at time of discharge of all patients
  • Raises importance of real time documentation
  • Allows us to estimate co-insurance % and again, eliminate need to bill later for that amount
  • Procedure is called OE.ORD.bill
final bill w in 3 5 days
Final Bill w/in 3/5 Days
  • If you can’t do it real time – we need to be able to do it by the 3 day IP/5 day OP cutoff
  • Late charges – after 3/5 day and after coding and dropping - $40,167 in July
  • Otherwise the bill drops and the claim has to be adjusted and refiled
  • Patient could be billed later, receiving second bill
  • Rework for charge entry, billing, coding and unfriendly to patient
changing the face of billing
Changing the “face” of billing

Our vision…

  • All insured patients will be sent a patient friendly billing letter when their insurance has been filed that will include the following:
    • Thank you to the patient for choosing CMH
    • Insurance information on file and who to contact if the information needs to be updated
    • Information about what to expect next (i.e. statement once insurance(s) has processed their account that includes a summary of charges)
  • Once the balance is the patient’s responsibility, the patient will be sent a statement that will include a summary of charges. If the patient is eligible for a prompt pay discount, discount will be included on the statement
  • amount and discounted total We will offer our patients a quick and easy way to view and pay their bills online
  • As an account progresses, the patient will receive progressive statements and/or letters with information about how to set up payment arrangements or what to expect if their account remains unpaid
our plan to get there
Our plan to get there…
  • Setup self pay routines in Meditech
  • Sign with a statement service, such as Emdeon’s ExpressBill, in order to obtain patient friendly correspondences
  • Move self pay billing and collections to Meditech
  • Purchase an online solution, such as Verus’ Online Patient Accounts Center (vPAC), that will allow our patients to view and make payments online
in the future
In the future…
  • View Access for Patients
  • Patients Self Check Kiosks
  • Registration Scrubber
thank you

Patient Friendly Registration and Billing

Thank you!

Questions and Comments?

Kim Tilley

IS Specialist

Citizens Memorial Healthcare

Phone: 417.328.6718

Email: ktille@citizensmemorial.com