Responsibilities:
- Responsible for performing the new patient intake procedures
- Responsible for identifying appropriate candidates for home medical equipment
- Evaluates patients referred for treatment to determine appropriateness for admission
- Responsible for obtaining initial and ongoing insurance/managed care benefits for insurance providers
- Familiar with standard concepts, practices, and procedures within the home medical equipment field
- Relies on limited experience and judgment to plan and accomplish goals
Patient Care Coordination:
- Answers phones and takes care of patients questions and concerns
- Provides customer service
- Schedules equipment set-ups and pick-ups
- Gets all required information (i.e. verify address, directions, payment information, etc) to set up a patient with equipment
- Follows up with total knee replacement patients and/or post- op patients to find out discharge date from hospital/status
- Handles all incoming pop-up orders accordingly
Billing:
- Requests authorization for any type of insurance, including medicare Replacement HMOs, Commercial insurances, etc.
- Initiates referrals process with Medicare HMO plans
- Assures that insurance gets verified electronically or via phone
- Ensures that diagnosis and HCPS and units are correct and match item provided to patient, as well as authorization
- Familiar with billing process
- Initiates appeals process for denied authorizations
- Initiates Work Comp authorizations, negotiates pricing with adjusters and third parties
Administrative Duties:
- Maintains tracking boards
- Creates cards for all orders
- Tracks progression from Probability→To Be
Scheduled:
- Creates schedule for Patient Care Representatives
- Records meeting minutes
- Tracks overdue script list
- Distributes faxes
- Enters/Tracks orders
- In Cortex
- In Busy Cal
- In the Patient Tracking Log
- Creates files for all orders
- Makes sure all necessary information is in the file
- Requests clinical notes from doctor’s offices
- Assists Office Manager and Billing Coordinator
Insurance Verification/Payment Arrangements:
- Verifies status of patients insurance, auto or worker’s compensation coverage
- Offers patients private pay rate for non-covered equipment and non-covered rental extensions
Coordinate Patient Care Representatives Schedule:
- Prints a daily schedule listing all set-ups and pick-ups
- Includes set-up tickets with maps and directions
- Includes pick-up tickets with maps and directions
- Includes any equipment exchanges
- Supplies accurate directions and maps to locate patients home
- Coordinates weekend schedule
- Lists all scheduled set-ups
- Lists all possible set-ups