This position works with patient families to educate them on applicable insurance benefits and payment options for out of pocket amounts due. For uninsured and underinsured patients, the Family Financial Services Counselor works with the family to assist them in obtaining 3rd party covered through government and/or commercial plans and also walks them through the PCH financial assistance application process. This position provides a customer service friendly approach that is coordinated with the patient's care team in order to ensure that the family has a full understanding of liability, coverage and coverage options, and payment options.
- Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
- Excellence in clinical care, service and communication
- Collaborative within our institution and with others who share our mission and goals
- Leadership that set the standard for pediatric health care today and innovations of the future
- Accountability to our patients, community and each other for providing the best in the most cost-effective way.
- Meets with insured patient's parent/guardian to: Explain relevant benefits and applicable out of pocket amounts based on data obtained through various electronic tools and in payer websites. Determine family's ability to pay. Review existing balances with families. Develop a comprehensive plan to cover out of pocket amounts which may include one or more of the following: -Prompt pay discounts -Secondary coverage -Payment plans -Financial assistance/sliding scale discount -Other options Assist with the resolution of billing inquiries by facilitating process with customer service.
Meets with self-pay patient's parent/guardian to:
- Assess options for coverage payment which may include one or more of the following:
- Prompt pay discounts
- Commercial coverage
- Government coverage
- Financial Assistance/sliding scale discount
- Provide patient estimates prior to service to assist patients in determining cost of services and options for payment.
- Provide accurate and timely documentation for patient's accounts explaining activities and interactions with family members, staff, and outside sources on behalf of the patient.
- Provide complete and orderly financial assistance packets to management for review and approval.
- Tracks all financial assistance applications in central repository.
- Works collaboratively with PCH/PCMG departments, payers, and vendors on behalf of the patient.
- Maintains a general understanding of the Federal Marketplace, Medicare, Managed Care, AHCCCS, and other third party payer rules, authorization and billing requirements.
- Provides feedback to management regarding work related problems and assists with resolution to provide excellent customer service.
- Performs miscellaneous job related duties as requested.