Revenue Cycle Time Line: PAS Quality Review

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 account data is accurate, meeting both clinical and financial needs

Activities and Considerations:

To understand the importance of quality in Patient Access Services, review any portion of the timeline leading up to Quality Review.

Quality Review processes help ensure individual performance. A 90% accuracy rate is no longer acceptable. Manual sampling review processes need to be improved with automated tools to confirm accuracy and completeness of all accounts.

The host system should offer tools to assure the accuracy of data. Where internal tools are not available, HL7 data feeds can be configured to capture and review registration data sets, reporting know and suspected errors to individual registrars and management.

Automated data reviews should include:

Address comparison with credit file and other national address database records

Insurance benefit verification or insurance plan number character validation

Insurance plan address verification

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In addition, document imaging databases should be reviewed for documents added for each patient registered. Missing document lists should be compiled by registrar for deficiency reporting.