Patrick Marston, Ms,Msm Email & Phone Number

Bear, DE, US

• Manage the day-to-day operations of the home care service office
• Track and trend various metrics including weekly income, daily admissions, accounts receivable and referral management
• Direct management of office staff including clinical manager, rehab manager and client services manager with indirect oversight of all field clinicians.
• Regular communication and collaboration with business development staff to strategize growth within the home health marketplace
• Oversight of Quality Assurance and Performance Improvement programs
• Maintain oversight of all employee files and records to maintain compliance with both internal and external requirements

Philadelphia, PA

Manage all concurrent reviews for a 36 bed private inpatient geriatric psychiatric unit. Complete weekly chart audits for all Medicare patients to ensure compliance with billing and medical necessity criteria. Serve as a member of the senior leadership team and sit on various hospital committees pertaining to hospital operations and patient safety.

Newark, DE

• Manage employees of the Utilization Review department.
• Maintain records of denials from insurance companies and underutilized insurance authorizations and analyze for trends; report all analyzed data to the hospital Quality Council on a monthly basis.
• Maintain and report daily discharges from the hospital and analyze for trends.
• Coordinate daily with the business office and CFO regarding insurance denials and update on the status of any open appeals.
• Participate as a member of the hospital leadership team in daily treatment team meetings as well as daily operations meetings.
• Complete monthly chart audits of all existing Medicare charts to ensure compliance and medical necessity.

Newark, DE

• Complete prior authorizations for members who are seeking inpatient, partial hospital, or intensive outpatient psychiatric or substance abuse services. Obtain all clinical information from the referring facility or.
• Conduct concurrent reviews and in conjunction with a licensed nurse or therapist determine medical necessity criteria for members who are participating in psychiatric and/or substance abuse intensive outpatient services.
• Enter outpatient behavioral health authorization requests into the computer in a timely manner.
• Help to educate and assist providers on the Delaware Physicians Care Inc behavioral health benefits, authorization, and claims process.

New Castle, DE

Completed concurrent reviews with managed companies; maintained records of insurance authorizations, denials and appeals; facilitated discharge planning for patients.

Havre De Grace, MD

Completed intake assessments and admission paperwork, completed insurance authorizations, triaged crisis phone calls.

Master Of Science (M.S.), Health/Health Care Administration/Management

Master'S Degree, Human Services

Bachelor Of Arts (Ba), Psychology

Highschool Diploma, College Prep