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Comprehensive Training in Billing, Collections and Decision Making

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In addition to implementing a new system, the most important part of the puzzle is to train the PFS staff effectively and as comprehensively as possible to deal with known problems in the registration, billing and collections process. Workers compensation for accident coverage may not be evident, the patient’ s guarantor may be under 18 years of age, the marital status might be widowed with no next of kin information available, they may be over 65 years old with no Medicare insurance plan, the secondary payer questionnaire is missing, etc. Another issue regards patients with duplicate medical records, duplicate addresses, returned mail for billing payments and delinquent accounts at the hospital combined with bad ratings for credit card usage.

According to the paper findings, it can, therefore, be said that in these cases, a clear plan of action has to be implemented in accordance with office policies. It has simplified the decision process somewhat, yet the bulk of decision making still remains in the hands of the PFS staff.   There are always some new situations that crop up now and then. It is evidently clear from the discussion that a  denials management system has also been instituted, enabling management to recognize the most common and unique problems being encountered and whether a solution can be arranged that can cover some problem areas and increase the rate of admissions and registrations.     The author of the paper states that the training program at Sutter Health concentrates on the problem areas of both CBO and PFS staff.

While CBO staff is not reluctant to ask for cash upfront, they often are flummoxed by the idea of taking responsibility for individual patient cases.

On the other hand, PFS staff is generally not accustomed to asking for cash during the process of registration and admissions. They have to be trained to do so while generally accepting responsibility for patient collections.  

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