Term
| PATIENT ACCESS TYPICALLY INCLUDE..... |
|
Definition
- Focus on customer service/ first impression
- Train admitting staff to become "salesperson"
- Ensure that admitting staff is well educated and call answer questions
- Identify mechanism to decrease wait time
- Pre-register patients whenever possible
- Make the process positve and painless
|
|
|
Term
WHAT ARE THE PRIMARY FUNCTIONS AND RESPONSIBILITIES OF PATIENT ACCESS?
|
|
Definition
- SCHEDULING
- PRE-REGISTRATION AND PRE-ADMISSION TEST
- PRE-CERTICATION AND PRE-AUTHORIZATION
- INPATIENT ADMITTING/OUTPATIENT REGISTRATION
- INSURANCE VERIFICATION
- FINANCIAL COUNSELING
|
|
|
Term
NORMALLY IT IS WHOSE RESPONSIBILITY TO SCHEDULE PATIENTS' APPOINTMENTS?
|
|
Definition
RECEPTIONIST
(ALL MEASURES TO ACCOMODATE THE PATIENT SHOULD BE TAKEN INTO CONSIDERATION) |
|
|
Term
| THE EXCELLENCE OF MANAGEMENT IN THE SCHEDULING PROCESS REQUIRES WHAT? |
|
Definition
BALANCE BETWEEN:
- PATIENT SATISFACTION
- THE COLLECTION OF FINANCIAL, DEMOGRAPHIC, AND INSURANCE INFORMATION
- CLINICAL SERVICES
|
|
|
Term
| WHAT INFORMATION IS GATHERED DURING THE PRE-REGISTRATION/ ADMISSION PROCESS? |
|
Definition
- PATIENT DEMOGRAPHIC
- FINANCIAL INFORMATION
- SOCIOECONOMIC INFORMATION
|
|
|
Term
| IT IS RECOMMENDED THAT BETWEEN _____% AND ____% OF ALL SCHEDULED ADMISSIONS BE PRE-REGISTERED WITHIN 24 HOURS OF THE SERVICE DATE. |
|
Definition
|
|
Term
| BY IMPLEMENTING THE PRE-REGISTRATION PROGRAM, COMPLAINTS SHOULD DECREASE DUE TO WHAT? |
|
Definition
- FINANCIAL PLANNING AND COUNSELING DONE IN ADVANCED
- PATIENT BECOMES FAMILIAR WITH PROCESS
- SPECIAL NEEDS CAN BE IDENTIFIED AND ACCOMMODATED
- PATIENTS ARE MORE PREPARED
- ADMISSION TIME IS REDUCED
|
|
|
Term
|
Definition
|
|
Term
| THE DIAGNOSTIC MEDICAL SCREENING OF PATIENTS IN ADVANCE OF SURGICAL OR INVASIVE PROCEDURES TO DETERMINE HOSPITALIZATION AND/OR SURGICAL SUITABILITY. |
|
Definition
PRE-ADMISSION TESTING
(PAT) |
|
|
Term
| CONSIST OF THE INSURANCE COMPANY REVIEW ORGANIZATION APPROVING THE MEDICAL NECESSITY OF THE HOSPITALIZATION FOR A PATIENT. |
|
Definition
PRE-CERTIFICATION
PRE-AUTHORIZATION |
|
|
Term
| THE AUTHORIZATION TO TREAT A PATIENT AND THE AUTHORIZATION FOR THE LENGTH OF STAY IS BASED ON.... |
|
Definition
|
|
Term
| INPATIENT ADMITTING AND OUTPATIENT REGISTRATION RESPONSIBILITIES INCLUDE..... |
|
Definition
- OFFER "GUEST SERVICES"
- APPLY PATIENT IDENTIFICATION PROCESS FOR FUTURE RECORDS
- INITIATE THE MEDICAL RECORD FOR STAY
- CREATE PATIENT ACCOUNT FOR TREATMENT/ CONDITION
- ASSURE THE ACCURACY OF PATIENT ACCOUNT RECORD
- COLLECT BASIC DATA AND VALUABLES
- VERIFY INSURANCE
|
|
|
Term
| TPA IS ABBREVIATED FOR... |
|
Definition
| THIRD PARTY ADMINISTRATOR |
|
|
Term
| THE ROLE AS FINANCIAL COUNSELOR TYPICALLING INCLUDES: |
|
Definition
- VERIFY DEMOGRAPHICS OF PATIENT
- OBTAIN BASIC FINANCIAL INFO
- ESTABLISH THE ABILITY TO PAY&INITIATE APPLICATION FOR FINANCIAL ASSISTANCE IF NEEDED
- EXPLAIN HOSPITAL COLLECTION POLICY
- OBTAIN INFO REGARDING 3RD PARTY INSUR.
- VERIFY AVAILABLE BENFITS THRU INSURANCE
- CALCULATE THE PATIENT ESTIMATED RESPONSIBILITY
|
|
|
Term
| DURING FINANCIAL COUNSELING THE PATIENT'S ESTIMATED COST IS CALCULATED BASE ON WHAT FACTORS? |
|
Definition
- THE AVE. LENGTH OF STAY FOR DIAGNOSIS
- THE AVE. COST PER DAY BY TYPE OF SERVICE
- ADMITTING PHYSICIAN EST. LENGTH STAY
- AVE. COST OF PROCEDURE PERFORMED
- HOSPITAL RATE PROCEDURES/ DRG/ CONTRACTUAL ALLOWANCE
- DAILY ROOM CHARGE BY TYPE (ICU,CCU,SEMI)
- PATIENT THIRD PARTY INSURANCE PLAN BENEFIT LEVELS
- NOTIFY RESPONSIBLE PARTY OF FINANCIAL OBLIGATIONS
- REQUEST PAYMENT IN FULL
- ESTABLISH PAYMENT ARRANGEMENTS
- COMPLETE ALL PRE-ADMISSION PAPERWORK
|
|
|
Term
| WHAT ARE THE FIVE COLLECTION CONTROL POINTS? |
|
Definition
- PRE-ADMISSION
- ADMISSION
- IN-HOUSE
- AT DISCHARGE
- AFTER DISCHARGE
|
|
|
Term
|
Definition
ESTIMATED PORTION OF THE BILL NOT COVERED BY INSURANCE
(CAN BE COLLECTED PRIOR TO ADMISSION, AT ADMISSION, OR AT DISCHARGE) |
|
|
Term
| WHAT ARE THE ADVANTAGES OF A DEPOSIT COLLECTION PROGRAM: |
|
Definition
- INCREASE HOSPITAL CASH COLLECTIONS
- REDUCED OVERALL ACCOUNTS RECEIVABLE
- REDUCED FINANCIAL RISK AND BAD DEBT
|
|
|
Term
| AFFILIATED HEALTH SERVICES INCLUDED: |
|
Definition
- 24HOUR ACCESS TO RN OR QUALIFIED NON PHYSICIAN PRACTIONER (NPP)
- TELEPHONE TRIAGE
- HALTH INFO & RESPONSE TO INQUIRIES
- REFERRALS FOR PHYSICIAN/ SERVICES
- CUSTOMER SERVICE/ SATISFACTION FEEDBACK
- REGISTRATION FOR MEDICAL EDUCATION PROGRAMS
- COMPLIANCE MONITORING
|
|
|
Term
| PHYSICIAN DIRECT SERVICES INCLUDE |
|
Definition
- COMMUNITY REFERRAL ASSISTANCE
- STAFF PHYSICIAN SPECIALTY REFERRAL ASSISTANCE
- PCP NOTIFICATION OF PATIENT THAT EXPERIENCED EMERGENCY ADMISSION
- STAFF PHYSICIAN OUTBOUND CALL SERVICES
- MARKETING FOR STAFF PHYSICIAN
|
|
|
