Brown University Health
Overview
SUMMARY: Under the general supervision of the Supervisor, but according to established policies and procedures, interviews, pre-register/registers and admits patients. Financially clears accounts for Admission and other Ambulatory Departments by obtaining demographic, third-party insurance and related financial information, using LifeChart. Initiate, review and follow-up on patient accounts to ensure proper data collection for billing, review any existing account balances for previous hospital services, request cash deposit by approximating charges for scheduled services or co-payments or co-insurance if applicable. Arranges payment agreement and contacts the Patient Financial Advocates when applicable and makes preliminary determination on welfare eligibility and /or RIH Financial Assistance program. Verify all demographic and insurance information and obtain and/or apply for the referrals and/or authorizations from the payers as required by Hospital policies. Brown University Health employees are expected to role model the organization\'s values of Compassion, Accountability, Respect, and Excellence as these values guide actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences, Patient and Community Focus and Collaborate.
Responsibilities
Interview patients or a patient representative to obtain complete and accurate personal and financial information; follow up on missing data by interviewing patients, families or calling employers, nursing homes and other facilities.
Utilize multiple systems to validate the accuracy of patient\'s health insurance, acquire authorization and patient\'s financial liability.
Contact patients/families to complete pre-admission demographic and financial information including patient copays, deductibles, co-insurance and outstanding balances.
Complete Medicare Secondary Questionnaire, Liability information, etc. when applicable. Mail Welcome Brochure.
Validate patient\'s insurance using Passport eligibility system, phone calls to insurance company or payer web-site. Obtain authorization for inpatients, observation and selected outpatients.
Contact patient and physician\'s if payer denies authorization approval. Review outpatient/observation pre-admission Medicare patients to ensure correct patient class following Medicare status requirements. Follow up with physicians when applicable.
ABN – Advance Beneficiary Notice validates for selected outpatient services for Medicare patients if services are covered. Work with physician\'s office to ensure accuracy of selected procedures.
For in-house patients, obtain appropriate authorization for patient class changes and visit patients on the nursing unit to explain changes in financial responsibilities. Follow up on all missing information and unsigned documents for ED Admissions.
Meet with patients/families when Medicare patients have used all inpatient coverage days and can opt in or not to use Lifetime Reserve Days. Make payment arrangements if they choose not to use Lifetime Reserve Days.
Validate RI Medicaid or Mass Health insurance plans for managed care products and obtain authorization for daily in-house patients. Validate insurance on the first of each month for in-house patients.
Pre-Admission testing registration – complete all necessary demographic and financial information for admission, including necessary information for the admission, welcome booklet and Advanced Directives. Complete Pre-Admission registration. Direct Admission is completed on the Nursing unit by the Patient Account Representative.
Self-pay patients - refer to Medicaid Specialist/Patient Financial Advocate. Complete waiver for “Non-Covered Services” for Non-Medicare payers and “No authorization at time of service” for Non-Medicare payers.
Coordinate daily admission reports for payers. Greet and direct all patients, families and visitors in a prompt and courteous manner.
Arrive Admissions: Scan identification, take patient photo, obtain patient agreement signatures according to policies, review HIPAA disclosures and provide related information.
Document all information into LifeChart and follow the Over the Counter Policy by logging payments and providing receipts per department policy. Communicate with service departments to obtain MD order information as required.
Utilize LifeChart and related systems to complete daily work; follow policies for the listed systems and procedures.
Attend and participate in staff meetings; protect patient privacy and confidentiality. Perform other duties as assigned.
Minimum Qualifications
Basic knowledge:
A level of knowledge generally obtained through completion of High School. Well developed interpersonal and communication skills to obtain patient information and communicate effectively with the public. Ability to respectfully set payment arrangement terms and collect payments. Knowledge of third party health insurance authorization/validation.
Experience:
Preferred Epic ADT/Cadence and/or Billing experience. Two year minimum experience in a hospital, physician setting or health insurance company.
Work Environment and Physical Requirements Working conditions are generally good in a normal working environment.
Supervisory Responsibility N
Pay Range $18.66-$30.77
EEO Statement Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
Location Rhode Island Hospital - 593 Eddy Street Providence, Rhode Island 02903
Work Type 8:30 am - 5:00 pm
Work Shift Day
Daily Hours 8 hours
Driving Required No
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SUMMARY: Under the general supervision of the Supervisor, but according to established policies and procedures, interviews, pre-register/registers and admits patients. Financially clears accounts for Admission and other Ambulatory Departments by obtaining demographic, third-party insurance and related financial information, using LifeChart. Initiate, review and follow-up on patient accounts to ensure proper data collection for billing, review any existing account balances for previous hospital services, request cash deposit by approximating charges for scheduled services or co-payments or co-insurance if applicable. Arranges payment agreement and contacts the Patient Financial Advocates when applicable and makes preliminary determination on welfare eligibility and /or RIH Financial Assistance program. Verify all demographic and insurance information and obtain and/or apply for the referrals and/or authorizations from the payers as required by Hospital policies. Brown University Health employees are expected to role model the organization\'s values of Compassion, Accountability, Respect, and Excellence as these values guide actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences, Patient and Community Focus and Collaborate.
Responsibilities
Interview patients or a patient representative to obtain complete and accurate personal and financial information; follow up on missing data by interviewing patients, families or calling employers, nursing homes and other facilities.
Utilize multiple systems to validate the accuracy of patient\'s health insurance, acquire authorization and patient\'s financial liability.
Contact patients/families to complete pre-admission demographic and financial information including patient copays, deductibles, co-insurance and outstanding balances.
Complete Medicare Secondary Questionnaire, Liability information, etc. when applicable. Mail Welcome Brochure.
Validate patient\'s insurance using Passport eligibility system, phone calls to insurance company or payer web-site. Obtain authorization for inpatients, observation and selected outpatients.
Contact patient and physician\'s if payer denies authorization approval. Review outpatient/observation pre-admission Medicare patients to ensure correct patient class following Medicare status requirements. Follow up with physicians when applicable.
ABN – Advance Beneficiary Notice validates for selected outpatient services for Medicare patients if services are covered. Work with physician\'s office to ensure accuracy of selected procedures.
For in-house patients, obtain appropriate authorization for patient class changes and visit patients on the nursing unit to explain changes in financial responsibilities. Follow up on all missing information and unsigned documents for ED Admissions.
Meet with patients/families when Medicare patients have used all inpatient coverage days and can opt in or not to use Lifetime Reserve Days. Make payment arrangements if they choose not to use Lifetime Reserve Days.
Validate RI Medicaid or Mass Health insurance plans for managed care products and obtain authorization for daily in-house patients. Validate insurance on the first of each month for in-house patients.
Pre-Admission testing registration – complete all necessary demographic and financial information for admission, including necessary information for the admission, welcome booklet and Advanced Directives. Complete Pre-Admission registration. Direct Admission is completed on the Nursing unit by the Patient Account Representative.
Self-pay patients - refer to Medicaid Specialist/Patient Financial Advocate. Complete waiver for “Non-Covered Services” for Non-Medicare payers and “No authorization at time of service” for Non-Medicare payers.
Coordinate daily admission reports for payers. Greet and direct all patients, families and visitors in a prompt and courteous manner.
Arrive Admissions: Scan identification, take patient photo, obtain patient agreement signatures according to policies, review HIPAA disclosures and provide related information.
Document all information into LifeChart and follow the Over the Counter Policy by logging payments and providing receipts per department policy. Communicate with service departments to obtain MD order information as required.
Utilize LifeChart and related systems to complete daily work; follow policies for the listed systems and procedures.
Attend and participate in staff meetings; protect patient privacy and confidentiality. Perform other duties as assigned.
Minimum Qualifications
Basic knowledge:
A level of knowledge generally obtained through completion of High School. Well developed interpersonal and communication skills to obtain patient information and communicate effectively with the public. Ability to respectfully set payment arrangement terms and collect payments. Knowledge of third party health insurance authorization/validation.
Experience:
Preferred Epic ADT/Cadence and/or Billing experience. Two year minimum experience in a hospital, physician setting or health insurance company.
Work Environment and Physical Requirements Working conditions are generally good in a normal working environment.
Supervisory Responsibility N
Pay Range $18.66-$30.77
EEO Statement Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
Location Rhode Island Hospital - 593 Eddy Street Providence, Rhode Island 02903
Work Type 8:30 am - 5:00 pm
Work Shift Day
Daily Hours 8 hours
Driving Required No
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