CHAA ExaminationPreparation
Pre-Encounter – Session II
Pages 33-41
University of Mississippi Medical Center
What to Expect…
• This module covers various aspects of Patient Access knowledge found on pages 33-41 of the Pre-Encounter section of the 2010 CHAA Study Guide.
• A quiz at the end will measure your understanding of the knowledge covered.
Resource Scheduling• RESOURCE SCHEDULING is necessary to ensure
that there are STAFF, RESOURCES and EQUIPMENT available to meet the patient’s needs.
• COORDINATING with different departments assists them in MAXIMIZING their department’s PRODUCTIVITY by managing their schedules accordingly.
• The overall goal of Resource Scheduling is to MAXIMIZE PATIENT FLOW and MINIMIZE PATIENT WAIT TIME.
Document, Document, Document!!!
The following phrase cannot be overstated:
“If it is not documented, it did not happen.”
• Be sure to note anything unique or special about the patient’s account in the appropriate section. Doing so protects your reputation by providing evidence that you did your job completely and accurately.
Continual Growth & Development
As a professional, you must constantly improve your ability to provide excellent customer service. Continually focus on the following areas:
• DON’T APPEAR RUSHED, even if you are. Treat the patient as if they are the ONLY ONE THAT MATTERS.
• Listen WITHOUT INTERRUPTING.• RELATE WITH YOUR EYES. Don’t gaze at your
computer screen during the ENTIRE interview.• EMPOWER your patients by encouraging them to
ASK QUESTIONS.• Provide MORE INFORMATION IN LESS TIME.
Pre-Registration
On a patient’s first visit to the facility, theyare assigned a unique ID number. This
numbercan be referred to as an:
• Enterprise Number• Master Patient Index Number• Medical Record Number
Medical Records• A patient’s medical record will be
maintained for a minimum of 10 years.• Patients can request a copy of their
medical records at any time.• A patient’s signature will be required any
time a non-referring/ordering physician, etc. requests a copy of their medical record.
• Patient’s medical records are always to be protected from any unauthorized review.
Patient Rights and Organizational Ethics
Patient’s have a fundamental right to receiveconsiderate care that safeguards their personal dignityand respects their CULTURAL, PSYCHOSOCIAL, and
SPIRITUAL values. Do so by:• Promoting consideration of patient values and
preferences, including the decision to DISCONTINUE TREATMENT
• Recognizing the hospital’s responsibilities UNDER LAW• Informing PATIENTS of their RESPONSIBILITIES in the
care process• Managing the hospital’s relationships with patients
and the public in an ETHICAL MANNER
Patient & Family Education
The goal of patient and family education is to provide accurate, consistent, and understandable information to patients
and their family about their healthcare TREATMENT and
ENVIRONMENT.
Clinical Pre-Requisites
Clinical pre-requisites are a MEDICALLYRELATED list of “do’s and don’ts” for thepatient to follow prior to their appointment.Examples may be:
– Don’t eat or drink anything other than water on the day of the appointment.
– Avoid using your inhaler (if possible) on the day of your pulmonary test.
Financial ClearanceAlso known as “Financial Pre-Determination,”
this is where the provider:• Identifies actual payment sources• Assists patients in determining their expected
reimbursement, out of pocket expenses, and alternative funding sources.
The goal is for the patient to understand their financial obligation PRIOR to providing services and avoid billing SURPRISES.
Point of Service Collections
• Refers to collecting the patient’s portion of the bill AT THE TIME SERVICE IS RENDERED.
• For patients who cannot pay their portions in full at time of service, make every effort to collect full payment before offering alternatives.
• Access Representatives working in outpatient departments are responsible for collecting DEDUCTIBLES and CO-PAYS whenever possible.
EMTALA• EMTALA is a federal law stating that all patients
who enter the Emergency Department must be SCREENED and STABILIZED before we can ask for payment.
• It was written to protect patients from discrimination based on ECONOMIC STATUS.
• Access Staff CAN ASK ED patients for a copy of their INSURANCE CARD PRIOR TO BEING SCREENED and STABILIZED but cannot discuss coverage or payments until the patient is stabilized.