SCA, a leader in the outpatient surgery industry, strategically partners with health plans, medical groups and health systems across the country to develop and optimize surgical facilities. SCA operates more than 200 surgical facilities, including ambulatory surgery centers and surgical hospitals, in partnership with approximately 3,000 physicians. For more information on SCA, visit www.scasurgery.com.
Facility Description: Memorial Care Outpatient Surgery Center of Long Beach, an SCA Afilliate is a large Multispecialty Ambulatory Surgery Center that serves four operating rooms and three procedure rooms. Approximately 1,200 monthly case volume.
The insurance verification teammate is responsible for ensuring schedule procedures are on the patient’s insurance coverage list for the patient meets self-pay criteria. The insurance verification teammate will be responsible for verifying insurance coverage, eligibility, benefits, obtaining authorization is in pre-Certs as required by the individual insurance company. The teammate will verify that all schedule procedures are on the ASC procedure listing. The insurance verifier will be familiar with and understand Medicare, Medicaid, other government payers, commercial and HMO/PPO payer guidelines and principles.
The insurance verification teammate will be responsible for calculating coinsurance estimates for the payer contract as applicable and amounts due from self-pay patients according to the center self-pay guidelines. The teammate will enter the verification, eligibility and a benefit information in the patient accounting system to include the date, time and method used to obtain eligibility for each patient.
The insurance verification clerk is responsible for communicating insurance benefit information financial responsibility to each patient during the pre-registration financial orientation call prior to the date of service. Verifier is responsible for verifying the patient demographic and insurance information along with subscriber information secondary insurance as applicable during the pre-registration financial orientation call.
SCA strives to provide excellent customer service to all patients and Pfizer shins by promptly and accurately verifying insurance, self-pay accounts and notification to patients prior to the date of service.
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