0001 - GJ-REV-0101- Patient Access & Revenue Preparation

Course Description

This course will emphasize the importance of assisting with patient access to healthcare.  Topics covered will be the essential front-end functions of a wide variety of healthcare facilities including scheduling, patient registration, eligibility, insurance authorization, financial counseling, and upfront patient collections. Students will explore how these functions are critical to an organization.  Participants will discuss how excellent customer service relates to receiving timely payment. As part of customer service, students will explore how empathy, health equity, implicit and unintended bias, and social determinants of health can affect the healthcare organization’s relationship with the patient. This training is suited to those with no healthcare or revenue cycle experience.

Learner Outcomes

1. Explain types of healthcare insurance such as BCBS, Medicare, and Medicaid
2. Discuss law and ethics related to working in the healthcare field with an emphasis placed on HIPAA and privacy and confidentiality of patient information.
3. Describe the steps taken to register and schedule a patient and perform a simulation of this process.
4. Explain the best practices and need for exceptional customer service in healthcare.
5. Identify the pertinent information that must be located on the review of a patient insurance card.
6. List the steps in performing a prior authorization for patient insurance coverage.
7. Describe the process for collecting payments from patients.
8. Discuss the need for financial counseling with patients and assisting them with understanding copay, self-pay, payment plans, deductible, out-of-pocket and collections.
9. Describe the basic steps of the revenue cycle.
10. Demonstrate professional communication and behavior.
11. Demonstrate the use of technology in front end tasks.
12. Discuss the concepts of health equity and disparities, bias, and social determinants of health and how these are related to the relationship between the patient and the healthcare organization.