1. Table of Contents • Admissions • Financial Counseling and Screening • Human Resources • Insurance • Pre-Admissions • Miscellaneous • Search All Forms Alphabetically • Acknowledgements • Right of Use • Submit Your Form This resource guide was made possible in part through an unrestricted educational grant from R&B Solutions. NAHAM Forms Guide The National Association of Healthcare Access Management (NAHAM) is the only national professional organization dedicated to promoting excellence in the management of patient access services in all areas of the healthcare delivery system. Why re-invent the wheel? NAHAM is happy to provide you with a compilation of sample patient access forms used and contributed by our own members. Find solutions to daily Access-related challenges, such as tools for Quality Assurance, Charity Care Screening, Co-Pay and Deductible, and much, much more! In this comprehensive guide you can download, customize, and make use of: Templates • Letters • References Examples• Policies & Procedures X

2. X Admissions Admitting Orientation Outline Outpatient Registration Orientation Outline Advance Beneficiary Notice (ABN) Performance Appraisal Form Advance Care Directive Form Letter Personal Information Revision Bed Log Private Room Information Call Log Private Room Request Form ER Co-Pay Collection Procedures Procedure for POS Cash Collection ER Orientation Outline Registration Co-Pay Form Groupwise Training Registration Training Objectives HDX Competency Questionnaire SMS Training for ER Registration Health Information Release Form SMS Training for Outpatient Registration NAHAM Forms Guide Financial C&S•Human Resources • Insurance • Pre-Admission • Miscellaneous • Alphabetical Listing