The Patient Access Technician-CHA is responsible for the accuracy and completion of patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include pre-admit/admit/pre-register/register functions, ensuring all insurance requirements are met prior to patients’ discharge, and pursuing cash .
1. Analyze insurance coverage and benefits for service to ensure timely reimbursement, obtaining all PAC and/or authorizations as appropriate.
2. Facilitate payment sources for uninsured patients.
3. Determine if patient’s condition is the result of an accident, performing complete research with law enforcement, employers, etc. to determine the appropriate source of liability/payment.
4. Admit/register/pre-register patients, correcting as necessary all patient demographic and financial data.
5. Resolve insurance claim rejections/denials and remedy expediently.
6. Calculate and collect cash payments appropriately for all patients, ensuring reconciliation of daily cash deposit.
7. Maintain general knowledge of CMS guidelines and third party payers, specifically, Medicare, Medicaid, Commercial insurances, HMO’s, PPO’s, POS, indemnity plans, and Worker’s Compensation, etc.
8. Evaluate diagnoses to ensure compliance with the Local Coverage Determination (LCD).
9. Perform those duties necessary to ensure all accounts are processed accurately and efficiently.
10. Promote and maintain excellence in customer service.
11. Documents all communication concerning patient’s financial responsibility in the Hospital Account Note in EPIC.
12. Tracks cancellations and no-shows. Informs physicians when a patient cancels or fails to come in for their appointment."