SCOPE OF SERVICE
1. Types and ages of patients served.
Patient Business Services customers include but are not limited to patients, guarantors, care providers, third party payers, other departments and functional areas inside and outside the organization.
2. Scope and complexity of patient care needs.
The Patient Business Services Department works together with other internal and external functional areas to effectively, seamlessly, efficiently and ethically manage patient accounts receivables. Services include, but are not limited to:
- Medicaid Eligibility
- Financial Counseling
- Insurance Verification
- Third Party Payer Billing
- Follow-Up & Collection
- Cash Posting
- Payment Review
- Denial Management
- Charge Description Master Maintenance
- Charge Capture
- Revenue Reporting
- Chart Auditing
- Customer Service
3. Methods used to assess and meet patient's care needs.
- Work within the Federal and State regulatory framework to achieve prompt and accurate payment for services rendered.
- Integrate clinical and financial information, meeting patient's needs and expectations for clear and concise financial communication.
4. How appropriateness, clinical necessity, and timeliness of support services are provided directly by the organization or through referral contracts.
Patient Business Services is responsible for daily billing and collections that play a critical role in the organization's financial viability.
5. Availability of necessary staff.
Patient Business Services hours of operation are Monday thru Friday 8am to 4:30pm.
6. Extent to which the level of care or service provided meets patient's needs.
Patient Business Services customer-focused approach integrates relevant data and processes throughout the organization to help ensure both customer satisfaction and revenue integrity.
7. Recognized standards or guidelines for practices used.
Patient Business Services operates in compliance with all Medicare and State Regulations and Guidelines.