Psych Admissions Coordinator l

Overview

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The McLean Hospital Corporation

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Psychiatric triage for all levels of care for McLean Hospital units on and off site, certain McLean affiliates, Partners facilities and capitated contracts. Provides teaching function for all evaluating clinicians regarding payers and precertification requirements.

• Provides Partners wide bed/service search following established triage procedure.
• Gathers clinical and financial information according to established procedures in order to make referrals to participating Partners facilities, (when available and outside Partners when needed) based on clinical needs and managed care contracts.
• Provide after hours psychiatric triage for Newton-Wellesley Hospital inpatient adult and geriatric facilities.
• Act as a resource to Partners wide facilities regarding services and bed availability within Partners.
• Provide psychiatric triage for Franciscan’s Children’s Hospital inpatient and ART (Adolescent Residential Treatment Program).
• Answer MGH/McLean Tufts line and provide triage, when indicated, or direction to other services.
• Provide public relations function by handling inquiries regarding services at McLean, its affiliates and other Partners psychiatric facilities.
• Maintain bed board for Partners facilities in order to be aware of bed availability.
• Interviews the patient, family member or referring professional to obtain clinical and demographic data to determine need for evaluation and/or admission; following established admission procedure.
• Gathers comprehensive and accurate information relevant to the need for evaluation and/or admission according to established procedure.
• Triages urgent and emergent calls to appropriate level of care including referral of patients in crisis to emergency rooms when indicated and/or contacting crisis team regarding patients at immediate risk, and when indicated contacting local police.
• Respond to preadmission inquiry promptly as indicated by lack of complaint.
• Interacts with patients, family member or referring professional in a courteous and professional manner as indicated by lack of complaint.
• With medically or psychiatrically complicated cases, reviews inquiry with Clinical Nursing Supervisor or Doctor on Call or department manager in a timely and professional matter as indicated by lack of complaint.
• Continually reassess census and bed availability.
• Assigns patient to appropriate unit based on census, clinical presentation at preadmission, and contract requirements.
• Obtains census (admissions, anticipated discharges on each inpatient unit at least three times during each twenty-four hour period and as indicated from McLean affiliates).
• Presents units with preadmission clinical information on patients and expected time of Arrival.
• Completes financial screening according to established procedure.
• Verifies insurance coverage via computer or telephone.
• Interprets insurance data to determine need for any special procedures and/or co-payments or deposits. Educates residents and other clinical evaluators regarding insurance and precertification requirements.
• Completes eligibility determination and fulfills all pre-registration requirements for major contracts and ensures that precertifications are complete.
• Reviews financial information with Patient Accounts Department or Director of Intake for approval when necessary.
• Communicates financial information to family member and/or referring agent as indicated by lack of complaint.
• Enters patient information and ADT transactions into the IDX system completely and accurately.
• Enters accurate patient demographic information into the system.
• Enters complete referral information into system to be used…