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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.

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Presentation on theme: "Patient Access Representatives. Patient Access Representatives are generally the first exposure a patient/customer has to a medical facility. Their attention."— Presentation transcript:

1 Patient Access Representatives

2 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

3 Responsible for all front-end functions at a medical facility:Responsible for all front-end functions at a medical facility: Patient registrationPatient registration Insurance verificationInsurance verification Up-front collectionsUp-front collections Patient education about their patient rightsPatient education about their patient rights Front end organization and operationsFront end organization and operations

4 Skills and Characteristics Good communication skills (speaking & listening)Good communication skills (speaking & listening) Understands proper telephone etiquetteUnderstands proper telephone etiquette OrganizedOrganized Cheerful, calm, courteousCheerful, calm, courteous Friendly, efficientFriendly, efficient Able to follow directions/training protocolsAble to follow directions/training protocols Sees the big-picture in regards to their impact on the facilitySees the big-picture in regards to their impact on the facility

5 Knowledge Areas Knowledgeable about hospital policies and proceduresKnowledgeable about hospital policies and procedures Knowledgeable about patient’s rightsKnowledgeable about patient’s rights Understand basics of insurance benefits and how to calculate patient responsibilityUnderstand basics of insurance benefits and how to calculate patient responsibility Understands the impact that their role plays on the facility (financially, informatics, etc)Understands the impact that their role plays on the facility (financially, informatics, etc)

6 Understanding HIPAA & PHI Health Insurance Portability and Accountability ActHealth 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?

7 Understanding Insurance DeductibleDeductible Co-payCo-pay Co-insuranceCo-insurance Out-of-pocket maxOut-of-pocket max Managed CareManaged Care BenefitsBenefits


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