Benefits Verification: Contacting insurance carriers via phone or portal to confirm eligibility, deductibles, copays, and co-insurance.
Prior Authorization: Obtaining necessary pre-authorizations for procedures, tests, or referrals to prevent denied claims.
Patient Communication: Explaining insurance coverage details and estimated out-of-pocket costs to patients.
Documentation: Updating patient records in the Electronic Health Record (EHR) system with accurate insurance data.
Scheduling/Rescheduling: Booking new appointments, rescheduling, or canceling appointments via phone or online platforms.
Calendar Management: Maintaining an accurate, up-to-date calendar, matching patient needs with provider availability.
Reminders: Sending reminders (call, text, email) to patients to reduce no-show rates.
Patient Intake: Collecting demographic and basic insurance information during the booking process.
Referral Processing: Managing incoming and outgoing referrals between primary care providers and specialists.
Tracking and Coordination: Monitoring the status of referrals, sending necessary medical records, and ensuring the specialist receives the patient information.
Scheduling Follow-ups: Following up with patients to confirm they have set up appointments with specialists.
Insurance Coordination: Working with insurance companies to ensure the referral is approved, particularly when the patient is being seen out-of-network.
HIPAA AWARENESS AND CERTIFICATION, BASIC OCCUPATIONAL SAFETY AND HEALTH TRAINING COURSE FOR SAFETY OFFICER 1 (2023), RETAIL PHARMACIST
EHR : Athena and ModMed
VOIP: Ring Central, Nextiva, Vonage
INSURANCE PORTALS:
Availity
Alameda Alliance
Alignment Health Plan
Affinity Med Group
Brown and Toland
Blue Shield of California
Carelon
Central California Alliance for Health (CCAH)
CHCN
Cigna
Evicore
Evolent
Dignity Health
Hill Physicians
Healthnet
Health Plan of San Mateo
Imperial Med Group
John Muir Health
Medicare
Medi-cal
Nivano
Northeast Medical Services (NEMS)
Optum/Physician med Group of San Jose
Partnership Health Plan of California
United Health Care
San Francisco Health Plan
SCCIPA
Sutter
Valley Health Plan
Triwest-Tricare
