Financial Counselor

Summary

Provides financial counseling to patients by interviewing patients, verifying insurance coverage, establishing payment arrangements, determining eligibility for financial assistance, and other related activities to maximize reimbursement to the Hospital for services rendered. Brown University Health employees are expected to successfully role model the organization s values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday 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.

• Demonstrates understanding of Hospital s Mission, Vision and Values.
• Demonstrates understanding of job description, performance expectations, and competency assessment plan.
• Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to our Customer Service Standards.
• Complies with department and hospital policies and procedures.
• Reviews policies and procedures; reviews Employee Handbook.
• Completes mandatory safety management education (hospital-wide, department-specific, job-specific).
• Participates in departmental and/or interdepartmental quality improvement activities.
• Reviews and analyzes all pre-admission, admission and outpatient account data daily to determine each patient s financial status.
• Contacts patients, employers and insurance companies as indicated to verify insurance coverage, patient balance responsibilities and determine eligibility for assistance.
• Meets with patients and/or their families to obtain needed third party billing forms, signatures of financial responsibility, collects private room balances, insurance co-payments and deductibles due.
• Reviews the scope, type and terms of health insurance contracts with patients and their families, utilizing the Hospital s financial policy to determine the adequacy of the coverage.
• Determines selected patients  eligibility for the Uncompensated Care and Bed Fund Programs by gathering the appropriate eligibility information to expedite approval or denial of assistance within the specified time frames of these programs.
• Processes applications for Uncompensated Care according to the Federal Register regulations.
• Refers patients in need of financial assistance to various state, federal and other agencies and, when necessary, completes application, obtains all required documents and files with the appropriate agency.
• Provides information to these agencies relative to the financial obligation of the patient, as requested.
• Initiates applications for catastrophic health insurance programs as appropriate.
• Follows up with patients who are rejected for assistance to discuss and arrange alternative reimbursement options before discharge from the Hospital.
• Negotiates payment schedules with patient and re-negotiates these schedules, as necessary, to accommodate changes in the patient s financial condition.
• Initiates promissory notes and promissory note payment arrangements and obtains proper signatures on the notes.
• Refers appropriate patients to selected banks to obtain loans for payment of Hospital services.
• Utilizes knowledge of the Newport Hospital charge and rate schedule to establish adequate and firm payment arrangements.
• Implements Newport Hospital s financial policies to maximize collections and decrease bad debts.
• Develops and maintains effective working relationships with local physicians, their office staffs, and other Hospital departments to ensure mutual understanding and acceptance of the Hospital s financial policies and to correct errors and clarify misunderstandings.
• Notifies other Hospital departments of reimbursement requirements relative to each individual patient account, as appropriate.
• Coordinates reporting of such information to the insurance carrier, being mindful of patients  rights while ensuring maximum reimbursement from third party payers.
• Documents all pertinent patient account information in the patient account notes regarding the scope of insurance coverage, billing instructions, prior payment listing, and patients  plans for payment of balances due.
• Revises and updates all patient demographic and/or insurance information in both Registration and Financial computer systems to ensure the continued accuracy of patient account data.
• Arranges inter-bank transfers of funds for patient payments including the wiring of monies from banks outside of the United States.
• Schedules patient s family interviews for discussion of limitations of coverage or payment denial issues at the convenience of the family, including hours beyond the regular scheduled business day.
• Obtains additional information as needed from the patient and/or his/her representative to ensure the timely filing of a Hospital lien, where a third party may…