MEDICAL VIRTUAL ASSISTANT
CALL TRIAGE
- Evaluate incoming calls to determine urgency and level of emergency.
- Document call details and forward messages to the appropriate personnel or transfer calls as necessary.
- Manage clinic voicemails and ensure timely callbacks.
SCHEDULING
- Inbound Calls: Manage appointment scheduling, rescheduling, cancellations, general inquiries, directions and other patient-related concerns..
- Outbound Calls: Confirm patient appointments two days in advance, handle rescheduling, and ensure the doctor’s daily schedule remains fully booked.
NEW PATIENT COORDINATION
- Set up new patient charts and verify insurance details.
- Collect and validate required documents (e.g., medical records, imaging, visit notes) from primary care providers (PCPs) or referring doctors.
- Schedule new patient visits and confirm all prerequisites are met.
ELIGIBILITY AND BENEFITS VERIFICATION
- Verify patient insurance eligibility and benefits through online portals or direct communication with insurance providers.
- Identify procedures that require prior authorization or pre-determination.
- Provide clear information on copays, deductibles, and insurance policies.
BILLING AND CLAIMS MANAGEMENT
- Submit and oversee insurance claims for performed procedures.
- Address claim disputes and denials, including direct communication with insurance companies.
- Collaborate with the prior-authorization team to ensure necessary authorizations are in place.
PRIOR-AUTHORIZATION
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- Submit and manage prior-authorizations for clinic procedures via online portals, phone calls, or faxes.
SCRIBING/TRANSCRIPTION
- Accurately transcribe medical notes and dictations for patient records.
- Medical Records Review
- Summarize extensive medical records for new patients to help providers quickly review patient history.
REQUEST FOR AUTHORIZATION (RFA) FOR WORKER’S COMPENSATION
- Complete RFA forms based on provider requests (e.g., consultations, imaging, medications, DME).
- Submit RFAs to claim adjusters, attorneys, or insurance companies.
FOLLOW-UP REQUESTS FOR WORKER’S COMPENSATION
- Follow up with insurance companies or claim adjusters on submitted RFAs.
- Verify patient claim adjuster details.
REFERRAL COORDINATION
- Refer patients to appropriate facilities, clinics, hospitals, or vendors based on insurance network requirements.