The Patient Financial Advisor (PFA) offers financial advice and assistance to patients regarding medical bills. PSA is the liaison between patients and their insurance companies; often coordinating payments and answering questions from both parties.
PFA shall ensure that appropriate reimbursement resources are in place for services provided. If patients are registered without insurance coverages, PFA will actively screen all inpatients and outpatients for other insurance coverages. Other responsibilities are:
1) verification of demographic and insurance information provided, as well as third party insurances;
2) Accurate and timely determination of payer and patient liability, and notifications and initial authorizations required;
3) Validate that required authorizations/notifications are obtained for hospital stay and outpatient services,
4) Adherence to government and non-government program requirements;
5) Effectively communicating with patients as to benefits, program requirements, personal payment liabilities, and options for care and placement that allow for informed decisions by the patient and his/her family while protecting the financial interest of Chinese Hospital Association;
6) Provides information regarding self-pay discounts when no other options are available, sets up payment arrangements as needed;
7) Discusses patient financial liability for services rendered and collects as applicable for those services;
8) Assist eligible patients in the application of Hospital Presumptive Eligibility (HPE), Full Scope Medi-Cal, and referrals to other insurance coverages if not qualifying for Medi-Cal;
9) Apply Treat Authorization Requirement (TAR) for all eligible accounts;
10) Review all assigned DNFB for appropriate billing actions.
