Patient Service Representative (PSR) (formerly Patient Service Coord) provides customer service, including telephone etiquette, cash management, schedules appointments, processes insurance updates and conducts patient check in/out. For access to the SOP manuals please go to the following web site: http://www.mc.vanderbilt.edu/epic/
Key Functions and Expected Performances:
Customer Service and Communication
RECEPTION AREA MANAGEMENT: Scan the reception area periodically to ensure that each patient is checked-in. If uncertain, verify patient's status. Proactively communicate wait times or delays to patients at the time of check-in. Provide updates to patients regarding revised wait times. Maintain an organized work area and professional appearance.
PHONE MANAGEMENT: Respond to each call with the standard greeting: Clinic name or other identifier; Your name; answer call within 3 rings. Place caller on hold with permission from caller and for appropriate time frames. Provide complete transfer assistance to all incoming calls when needed. Demonstrate phone service etiquette.
ON- AND OFF-STAGE BEHAVIOR: Demonstrate on-stage behavior in all settings viewed by patients or visitors. Demonstrate off-stage behavior expected in all settings when representing VU.
MESSAGING: Initiates message by correctly including the following information: Name; At least 2 of the correct identifiers (MR#, DOB, SS#); Reason for call or inquiry; Forwards messages to the appropriate recipient in a timely manner following clinical protocol. Respond to all messages using correct spelling, grammar and commentary appropriate for medical record documentation.
NEEDS ANTICIPATION: Demonstrate ability to identify and proactively assist a patient or visitor. Provide accurate and complete directional assistance independently or through the use of appropriate resources
Patient Sign-in: Ensure privacy by adhering to sign-in standard format; Ensure accurate patient identification by comparing sign-in data to 2 separate identifiers; Review "display notes" for Referral and Central Registration needs; Accurately determine which account to use for the visit. See Financial Screening Policy regarding payment responsibilities. Collect co-payments. Document in EPIC. Provide receipt. Determine if referral is needed from insurance and is in place for the visit.
Verify demographic & insurance information via open-ended questions: Name-Accuracy and Spelling SSN Address Phone-Work and Home Employer Insurance Information Emergency Contact Information. If insurance has changed, contact Central Registration to update the registration; Complete the MSP if Central Registration was unable to complete.
Scan & Index Insurance Cards (Medical Records SOP); Obtain card(s) from patient or guarantor and scan into StarPanel, using designated device; Categorize the card(s) within StarPanel; Rank each card as primary, secondary, or tertiary.
Prepare Encounter Forms: imprint with correct patient data Release of Information/Assignment of Benefits Clinical Intake Screening or History Forms
Manage Reception Area Maintain orderly appearance of reception area; Ensure method for accountability of each patient check-in; Proactively communicate with patients about delays; Manage reception area disruptions
Respond accurately to Frequently Asked Questions
Conduct Check-out and Charge entry according to standards
Collect encounter forms and verify accuracy and completeness- Date of service; Encounter # and billing #; Attending Physician's name and number; Clinic location code; CPT codes and modifiers; ICD-9 codes; Referring provider for new patients when consultation charge is marked.
Collect self-pay balances per clinic policy. Post professional charges; Reconcile charge batches; Balance cash collections to Use Batch Report daily; reconcile cash discrepancies. Prepare deposit and take to central depository or bank, daily; Reconcile petty cash and submit to central depository daily.
Complete Medical Records processes within StarPanel: If applicable, Scan and Index paper documents within the Image Queue, according to proper categorization for clinic area. Prepare Outside Medical Records for access during patient visit, either by creating a visit folder for the hard copies, or scanning in advance of the visit. Prepare paper patient charts for storage or consolidation with the main medical record.
Respond to patient or other requests for medical record copies by forwarding such inquiries to the Medical Records department for processing.
Incoming Patient & Referring MD Appointment Requests are scheduled according to clinic standards: Select account, if possible; Search/assign correct MR number; Enter referring physician, if patient is referred; Enter Primary care physician (PCP), if patient has one; Enter Self-Referred when appropriate; Schedule patients into the correct visit type for the correct physician; Complete patient demographic screen; If scheduling with MD office, put insurance information in display notes; If scheduling with patient, transfer to Central Registration for insurance registration.
Tests, Procedures & Outgoing Referral MD Appointment Requests are scheduled according to clinic standards: Complete ancillary requisitions accurately, according to written MD orders. Ensure presence of appropriately matched ICD-9 codes on 100% of ancillary requisitions; Explain test preparations to patients, according to practice protocols; Arrange for precertification if necessary; Coordinate all tests and referral appointments for clinical timeliness and patient convenience.
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