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Patient Access Representatives. Patient Access Representatives are generally the first exposure a patient/customer has to a medical facility. Their attention to good customer service and a high level of quality patient in reference to patient data is vital to the a medical facility’s success.
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Patient Access Representatives are generally the first exposure a patient/customer has to a medical facility. Their attention to good customer service and a high level of quality patient in reference to patient data is vital to the a medical facility’s success
Responsible for all front-end functions at a medical facility: • Patient registration • Insurance verification • Up-front collections • Patient education about their patient rights • Front end organization and operations
Skills and Characteristics • Good communication skills (speaking & listening) • Understands proper telephone etiquette • Organized • Cheerful, calm, courteous • Friendly, efficient • Able to follow directions/training protocols • Sees the big-picture in regards to their impact on the facility
Knowledge Areas • Knowledgeable about hospital policies and procedures • Knowledgeable about patient’s rights • Understand basics of insurance benefits and how to calculate patient responsibility • Understands the impact that their role plays on the facility (financially, informatics, etc)
Understanding HIPAA & PHI • Health Insurance Portability and Accountability Act • Governs the privacy of patient’s protected health information (PHI) • Who, what, when, and how’s of how patient information can be accessed • What role does the Patient Access Representative play in HIPAA? • Why is it important that these individuals are well educated/trained?
Understanding Insurance • Deductible • Co-pay • Co-insurance • Out-of-pocket max • Managed Care • Benefits
