Financially clears scheduled inpatient and outpatient services, including office visits, testing, diagnostic studies, surgeries and procedures, prior to date of service. Financial clearance process encompasses any or all of the following job functions:
• Verifies insurance eligibility and plan benefits.
• Contacts patients with inactive insurance coverage to obtain updated insurance information
• Validates coordination of benefits between insurance carriers.
• Explains insurance plan coverage and benefits to patients, as necessary.
• Secures insurance authorizations and pre-certs for patient services both internal and external to Cooper.
• Creates referrals for patients having a Cooper PCP. Contacts external PCPs to obtain referrals for patients scheduled with Cooper providers.
• Refers patients with less than 100% coverage to Financial Screening Navigators.
• Identifies copayment, deductible and co-insurance information.
• Collects and processes patient liability payments prior to service.
Provides clear and concise documentation in systems.
Communicates daily with insurance companies, internal customers, providers and patients.