Revenue Cycle Time Line: Demographic Data Capture and Confirmation

This article has links to allow easy access time line content from Scheduling to Bad Debt Recovery. Use this information as a starting point for planning, SWAT Analysis, or to review policies and procedures for gaps. Create a time line for your facility to assure all participants share the same expectations.

Goals:

· Assure accurate data is collected for clinical and financial needs

· Resolve any data integrity issues before discharge/release

Activities and Considerations

Accurate demographic information is important to assure the correct patient’s medical record is selected, the correct insurance is filed, and the proper individual is billed for self pay balances. Instances of identity theft and fraud are increasing in healthcare. Fraud is costly to everyone, (providers, insurance carriers and individual victims). Automation systems offer tools to help confirm the identity of individuals seeking care. Properly used, these can help mitigate risk of selecting the wrong patient record for care, and billing the wrong person’s insurance for coverage.

Technology solutions confirm demographics using nation-wide databases. If enough information is captured to confirm the match, this tool can help. Usually, an accurate name, SSN, State Driver’s License Number, or address will suffice. If, however, the wrong demographic is selected and imported as accurate, it associates the wrong person with a visit. Care should be taken to assure the correct patient information has been compiled.

In instances where electronic demographic data checking is unavailable, or fails to find a match in advance of (or during the time of registration), staff should ask open questions rather than asking whether the “patient’s phone number is still …” Some providers have staff call the phone number given by a patient to assure a correct number has been given.

Regardless of whether polling external databases, or relying upon the patient’s drivers license, healthcare providers should request and copy some form of identification to corroborate the identity. Unfortunately, this practice cannot be required of patients. Some providers are adding patient photographs at time of registration to help ensure the identity can be confirmed.