Medical Office Clerk Info Blog

Overcrowding in Emergency Rooms

medicalclerkinfo — Wed, 25 Apr 2012 09:17:15 +0000

Overcrowding in Emergency Rooms is not really an indication of facilities making more money. Generally, people are coming to the ER because they do not have insurance and/or cannot afford regular healthcare at a doctors office or Urgent Care Center. Most people know that they are supposed to be able to walk into any Emergency Room in the country and be able to receive medical service without having to pay for it upfront. In some cases that is not true. Such as when they are discharged the patients should be asked to pay their ER Copay, a deposit on self-pays or make some kind of payment arrangements for the same. Eventually the patients will receive a bill for services if their insurance company does not pay for the whole bill and if the patient didn’t pay their portion before they left the facility. Some patients will actually contact the billing office to make payment arrangements or fill out a charity form, if they qualify, and that helps with the bottom line. However, a vast majority of self pay patients simply ignore their bills. What can be done to reduce this trend? We, as Emergency Room Registrar’s, Patient Account Reps or whatever you are called, can do about this? Nothing really. It is up to your managers and administrators to decide how or if they are going to curb this trend in their area. Because of the Federal EMTALA rules we are required to give a “Medical Assessment” of anyone who comes in or is brought in for a medical emergency. There is a debate as to what, exactly, constitutes a Medical Assessment. Some feel that only an emergency room doctor can assess a medical emergency. Since, the ER Doctor is usually not the first person the patient sees then the patient will be waiting their turn a while, depending on the diagnosis or symptoms, before they get that far and we can actually do our jobs. What can be done to reduce the wait-time and weed out true medical emergencies from those that can wait?

There are several strategies out there that are receiving some widespread approval and may cost a little more in the beginning but are actually helping the overcrowding of the ER, reducing bad debt to the hospital and increasing collections from patients up-front. Thus, making our jobs a little bit easier. One of them is having a “Qualified Medical Person” in the lobby area assessing patients as they come in to determine if they have a “True Medical Emergency” and should be seen as quickly as possible or are what is considered low priority and can be required to register and pay for their services prior to receiving them. EMTALA only really guarantees that they will be assess and if necessary, to prevent loss of life, limbs or serious bodily damage to be treated as quickly as possible. In other words if you go into an emergency room with a cough, cold, scraps, toothaches, or non-specific abdominal pain then you will have to make payment arrangements prior to seeing the doctor for a prescription and any expensive tests.

Should everyone have access to decent medical care? Absolutely! However, should you go to an expensive Emergency Room just because you have a cough, cold, scrap or bruise. No! Emergency Rooms are for those people who are having a true medical emergency and cannot wait for the doctor’s office to open up. What can you do if you don’t have medical insurance or the wherewithal to pay for medical services? Check the yellow pages for services available in your area. If there are none then check with your local government and see what they are doing about it. Get together with your friends and relatives and start a petition to have the county you live in to create a “Free Clinic” that is opened nights and weekends. If you know any medical personnel such as doctors, nurses, medical lab techs, etc ask them if they can volunteer a few hours a week to help out. Contact local businesses and ask them to donate a small portion each month or once a quarter to help fund the supplies and equipment needed. You can even contact all the local hospitals and ask them to help with supplies, money and personnel. Hey, it is in their best interests to have a FREE clinic to help reduce their bad debt, reduce overcrowding and even get some good press in the bargain! Your community has to pull together if you want solve this problem.

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CHAA and CHAM Revisited

medicalclerkinfo — Thu, 15 Mar 2012 13:11:58 +0000

Certified Healthcare Access Associate exam and the Certified Healthcare Access Management exam are the only two, for now, certifications that we as Healthcare Access personnel can obtain to show current and future employers that we know our jobs and would make a great addition to their workforce. The exams are pretty straightforward, multiple choice, questionnaires that are administered by a designated proxy. The only caveat that each of them has is that you must be currently employed in the field. Because, generally, the proxy administering the test is usually someone from your place of employment. That proxy must also go through a mini training session to become certified to administer the test. And that person cannot be your direct supervisor but preferably someone from the Patient Access Training personnel pool.

About 3 to 6 months before you want to take the test you must send in your application with the appropriate fee as well as have the name and contact information of the proxy. NAHAM will contact the proxy with the information for administering the test and will certify them as proxies. If you are taking the CHAM exam you will need to have a recommendation from someone who already holds that certification and they must be willing to be your sponsor or reference. We suggest that if you do not have anyone at your place of employment already CHAM certified that you join your state’s chapter and attend a meeting and introducing yourself to several of the members. It doesn’t hurt to ask someone to review your resume and ask if they would be your reference for the exam. You can also join www.linkedin.com, upload your resume and join several of the organizations such as AAHAM, NAHAM and your state’s Healthcare Access Organization. Read through the discussions and participate as much as possible. Your insights and suggestions will show that you are a professional in this field.

Remember to check the NAHAM.org website for any changes in the fees or requirements for the exam. Some of the larger medical organizations may reimburse your testing fee once you have passed the exam so be sure and check with your Education/Training Departments. Good Luck and let us know when you pass. We love to celebrate with our fellow Healthcare Access people when they have accomplished their goals!

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National Healthcare Access Personnel Week

medicalclerkinfo — Sun, 26 Feb 2012 14:43:40 +0000

National Healthcare Access Personnel Week is coming soon. Only a few weeks away on April 1 – 7, 2012. If you are a manager for Healthcare Access Personnel we hope you are coming up with ways to Thank your personnel for all of their hard work this past year. It’s not too late to begin planning now. The National Association of Healthcare Access Management organization has a few suggestions on their website that you might want to incorporate to your own celebration: http://www.naham.org/?page=Activities

The website for NAHAM has been redesigned and very professional looking. You can even get a User name and Password for access to more information not available to the general public. For those of us who have taken the CHAA exam we already have a signon even if we haven’t become members of the National Organization yet. Even with limited access there is lots of information on this website. If you need to get more educational credits to maintain your certificate this is a great place to start.

Getting back to the Healthcare Access Week we hope you have a fun and educational week. As Managers, it is so important to make your employees feel appreciated and even small tokens and hand printed certificates or rewards will go a long way towards that goal. This would be a great time to incorporate refresher information on MSP, HIPAA, Red Flag Rules, EMTALA and other rules and regulations in game form. The employee to answer the most questions right might receive a gift certificate to a local restaurant or even one of the local theaters. You can use the questions off the CHAA study guide as well. Let your imagination go wild. Good luck and have a good time. Don’t let the nurses have all the fun!

Back to Work

medicalclerkinfo — Fri, 20 Jan 2012 19:12:10 +0000

Now that the holidays are over it is time we go back to work and prepare for a new year. And that means that almost everyone will owe another yearly deductible, may have changed insurances, may owe more for copays and most offices renew every patient’s signatures on the billing and authorization forms. The Front Office, Admission, Registration people will need to be spend a little bit more time with each patient to ensure that they have updated copies of the patient’s insurance cards, their photo ids, addresses and phone numbers.

Surprisingly, more and more people are changing their phone numbers on a fairly regular basis and holidays are the time that most phone companies are offering better deals to switch services. And, more and more people are turning off their land-lines and just using cell-phones as their main contact numbers. Updating a person’s contact information is very important not only for the Front Office Personnel to call and confirm appointments but the doctors and nurses may need to call the patient with results and, of course, the billing and collection people may need to call the patient about their balances.

When asking for a patient’s deductible payment prior to services you will need to know if they have received services anywhere else prior to the appointment with your office. Some patients may have already gone to the Emergency Room for services and depending on the timing, their billing practices, and even the deductible amount the patient may have already met their deductible with that visit. Most of your patients will have changed their insurances and/or their copayment amounts may have increased, as with everything else.

You will need to encourage patients to confirm that they are still within their network prior to making an appointment with your office. And if not, the least you can do is confirm it for them. There is nothing worse that finding out when you arrive or when you leave your appointment that you owe more than you have planned. Training your scheduling personnel in helping the patients with this information prior to scheduling saves a lot of misunderstanding and bad public relations.

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