Patient Access Rep

SUMMARY

Under the general supervision of the Supervisor, and according to established policies and procedures, interview and register all patients (Inpatient, Observation, Emergency, and Outpatients) to obtain demographic, third party insurance and related financial information, and enter it into the online computer system. Initiate, review and follow‑up on patient accounts to ensure proper data collection for billing. Verify all demographic and insurance information and obtain referrals as required.

Brown University Health employees are expected to successfully role‑model the organization’s values of Compassion, Accountability, Respect, and Excellence, guiding our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors that guide how we work together and get things done:
Instill Trust and Value Differences, Patient and Community Focus, and Collaborate.

Greets and directs all patients, families and visitors in a prompt and courteous manner. Interview patient or patient’s representative to obtain complete and accurate third party health insurance and related personal/financial information. Follow‑up on missing data by interviewing patients, families or calling employers, nursing homes and other facilities. Complete registration and enter all data obtained into the hospital computer system. Prepare or complete manual records as follows: ensure patients are properly identified in the system per department policy, verify demographic and insurance information by asking open‑ended questions, register all patients (Outpatient, ED, Inpatient and Observation) by entering and/or verifying demographic insurance information into the hospital information system, upgrade account status to active, complete documentation required on financial clearance reports as indicated by Patient Advocate or Pre‑Registration Office, utilize online tools and/or telephone to verify coverage, determine levels of benefits, confirm the primary care physician matches the PCP recorded in the hospital system, contact insurance carriers when necessary, notify Pre‑Registration Office if coverage changes from pre‑admit/pre‑registration information, identify primary and secondary insurers, record insurance information properly in the system, complete lien forms upon determination that a liability exists, enter financial notes into the system, gather paper referrals when required by the payer, update SMS with appropriate documentation, contact Financial Counselor/Pre‑Registration Office if the insurance does not verify or if the patient does not have a referral, utilize the system to determine self‑pay balances, use reference tools to determine expected payment due at the time of service, contact Patient Financial Advocate to estimate expected payment on complex cases, refer patients to Patient Financial Advocates if patients cannot meet the expected payment per defined criteria, collect co‑payments as required per financial clearance or third party payer or department policy (cash, check, credit card payments for ambulatory and Emergency services), document collections in the system, log payments, provide receipts, complete financial clearance screens, explain consent, financial and insurance forms to patients, obtain signatures on all required forms (Privacy notice, Ethics brochures, Patient Rights, Hospital Directory, The Miriam Hospital Welcome Brochures), generate patient registration record and plate, verify and update all information, make required plates, bracelets, and face sheets, place bracelet on patients per department policies in accordance with patient identification policy, utilize department scheduling and workflow reports to complete daily work, communicate with service departments for order information, communicate with Financial Counselor/Pre‑Registration Office for authorizations not obtained prior to service, ask patients for Advance Directive and include with admission paperwork, provide information on Advance Directives if none are prepared, explain and obtain patient sign on Advance Beneficiary…