Question
The Healthcare Financial Management Association says that inadequate or incorrect information gathered prior to care, is the single greatest reason for not billing or collecting
The Healthcare Financial Management Association says that inadequate or incorrect information gathered prior to care, is the single greatest reason for not billing or collecting accounts receivable in a timely manner. What do you think is the reason for this issue and what could be done to improve it?
Student's post: I believe multiple reasons account for false or incorrect information collected during the precertification period. One reason is the inadequate knowledge and understanding of employees in the precertification or pre-cert department. Although I cannot testify for all pre-cert employees/employers, my example is based on my employer/hospital. The pre-cert position's only requirement at my hospital is a high school diploma. Because this requirement provides no area of focus related to our country's healthcare payment system, the employees are left with inadequate understanding. These pre-cert employees do not understand insurance or patient care and are left to figure it out via on-the-job training. A second reason I believe information is gathered incorrectly is the pressure placed on the pre-cert department. Physicians and other providers depend on the accuracy of this information for their personal and department reimbursement. If reimbursement is so important to hospitals and many employees depend on their salaries, the hospital should establish additional requirements that are more specific to the job's responsibilities. Perhaps other requirements have not been implemented because hospital executives are hoping to save money by limiting the compensation of these important employees. Another solution is for hospitals and doctors to provide insurance and patient interaction training. The basic requirements of pre-cert employees should include possessing a kind spirit, being well-spoken, and having adequate knowledge of patient rights and insurance policies. Hiring qualified, robust individuals with knowledge of precertification tasks will reduce these given issues. After the issue is resolved, pre-cert employees can be compensated more for their highly specified training and efficient day-to-day work; after all, they are the sole reason for an organization's reimbursement.
Respond to this student's post that answered the bold/italics question. At least 300 words, please.
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