Provide pre-certification for imaging services for ColumbiaDoctors Radiology offices. Collect and verify patient’s insurance coverage, pre-certification requirements of patient’s insurer, update IDX registration, prepare and complete paperwork in preparation for patient’s imaging.
Efficiently and pleasantly work with referring physician offices; providing pre-certification services for referring physicians offices. Inform referring physician offices when pre-certifications are denied and work with the office to appeal the denied pre-cert.
Obtain all relevant patient clinical/demographic data from referring physician office and or EHR system.
Communicate with all parties including referring physician, Radiology and billing vendor regarding updated status of pre-certs.
Using web-based third party networks as well as telephone contact, obtain pre-certification for referring physicians. Review pre-certifications confirming that all studies are correctly pre-certified.
Input into IDX scheduling system pre-certification information adding patient financial notes as necessary.
Schedule appointments for Radiology clinical practice sites.
For add-ons, ensure that all required paperwork and authorizations are posted electronically in the EMR- obtain prior reports, images or other documentation as required to obtain authorization
Review schedule day before to ensure that all studies have been appropriately financially cleared.
High School Diploma, College preferred
Minimum three years of physician billing experience.
IDX medical billing and scheduling experience essential