According to national data from the Centers for Disease Control and Prevention, Motor Vehicle Accidents (MVAs) represent 4% of a hospital’s emergency room volume; however, they are often an overlooked source of revenue. MVA claims are complicated. They can involve multiple insurers and multiple billing parties, for this reason they are often the most difficult claims for hospitals to manage resulting in lost hours and revenue. However, a properly administered registration procedure can save the hospital time, frustration and money.
The hospital’s emergency room registration team is an important first step in a swift and accurate MVA lien process. Ensuring the registration team is asking the right questions and collecting the right information will expedite the lien process and lead to a higher reimbursement rate. Failure to record appropriate information related to an accident claim could result in undiscovered revenue sources and missed important filing deadlines. From the first hospital visit after a MVA, the hospital staff needs to understand and be trained to ask key questions that will ensure the hospital lien process begins properly. The first question every ER registrar should ask a patient is,
“Does your visit to the hospital today relate to an accident?”
If the answer to this question is “yes”, this should alert the registrar that additional information specific to an accident is needed for proper lien processing.
“Was this a motor vehicle accident?”
Confirming the type of accident can lead to information on insurance liability. Accident claims could involve multiple insurance coverage types including: automobile insurance, homeowner’s insurance, personal health insurance, commercial insurance, and employee compensation insurance. It is crucial that hospitals investigate all possible sources of insurance so claims can be filed accurately and timely.
Personal automobile insurance policies typically have either Medical Payment (MedPay) or Personal Injury Protection (PIP) coverage. MVA patients may not know which they have at the time of admittance. Both MedPay and PIP cover medical care and related expenses for the driver and passengers regardless of fault. Therefore, it is important that hospital staff be trained on how to determine coverage type. The requirement to have either coverage varies between states. Claims to MedPay are paid out on a first-come first-served basis. Both MedPay and PIP are primary in a MVA claims. However, their coverage usually has a defined limited payout.
“When and where did the motor vehicle accident occur?”
Capturing information on the time, date, city, state, or county can help the hospital locate an accident report, an important piece of the process. The accident report can help the hospital identify all involved parties and the insurance available at the time of the accident. The accident report may also identity the at-fault party. Once reliable information on the at-fault part is captured, the hospital can take steps to ensure the lien is properly perfected. Failure to bill the proper insurer could result in claim processing delays.
Hospital liens are complicated and time consuming for internal staff. Therefore, training and preparing hospital staff in the importance of patient registration and implementing these simple questions can dramatically improve the effectiveness of the MVA lien process.
Laws affecting hospital liens can be different from state to state. Many hospital staff lack the experience and expertise needed to navigate the entire process. Firms like, Argos Health, help hospitals take a methodical and tactical approach to addressing the challenges of MVA claims and prevent lost revenue.