Money Collected at Time of Service
Patient doesn't have insurance, how much do we collect at Check-in?
$200 is collected initially
Patient is a Banner Employee and has Banner Aetna Choice Plus, how much is collected at time of service?
$30.00 co-pay
What do we collect if Zotec states "Deductible has been met"?
Nothing, explain to patient it is showing deductible has been met and nothing is due today
Do we accept Out-of-State Medicaid?
No!
Patient states they were injured at work and will be going through Workers' Compensation. What is the process at check-in?
Have patient fill-out pink sheet completely (work injury report form) and update HIPAA forms.
*** FAX completed pink-sheet after provider fills out bottom portion to the Industrial Commission of AZ. (This can be submitted without the insurance information) ***
Do we collect payment from patients who have AHCCCS or Medicare?
No!
Patient is a Banner Employee and has Banner Aetna Value or Premier, what is collected at time of service?
$75.00 towards their deductible
What do we collect if Zotec states "Out of pocket has been met"?
Nothing, explain to patient that it is showing out of pocket has been met and nothing is due today
Do we accept AHCCCS Emergency, AHCCCS Behavioral Health Only, or AHCCCS QMB?
No! These AHCCCS plans DO NOT cover Urgent Care
Patient is a Veteran and is using their Veteran's Urgent Care Benefit, what is the process upon check-in?
1. Ask for Photo ID, VA Card, and their SSN
2. Call the VA Verification line to ensure patient is active and to activate the pharmacy benefit
3. Enter insurance as "Veterans Administration" and SSN as member ID
*NO Co-pay or deductible due at time of service*
What does Tier 1 Cash-pay include?
Basic office visit, in-house testing, in-house medications
Patient has AHCCCS but Zotec is saying amount due is $100, what do we collect?
$0, we NEVER collect for AHCCCS
Do we accept Kaiser Medicaid Products?
(This DOES NOT include Kaiser Commercial Plans)
No! We do not take Kaiser Medicaid (Out of State)
*Medicaid in California is called Medi-Cal*
Cash-pay Patient has outpatient labs ordered, what is the process for collecting the remaining balance?
Back office is to walk the patient back to front office to collect remaining balance, refer to BUCS Cash Lab Prices for pricing
What does Tier 1 Cash-pay not include?
Collected from the patient BEFORE leaving:
X-rays, sutures, TD, EKG (These are Tier 2 and will require extra $50 after the visit), Outpatient Labs (Collected before patient leaves clinic, pricing per BUCS cash-lab pricing sheet)
Not collected by us:
Outpatient imaging (Billed by outpatient imaging facility), DME (Billed by Breg), prescriptions (pharmacy)
Zotec states amount due is $50.86, but the insurance card states UC Copay is $50, what amount do we collect?
$50.00
Patient states their insurance isn't currently active, but will be in two days, what should we do?
Explain to patient that they will have to be a cash-pay because their insurance isn't active at time of service
Patient has two insurances: Commercial Insurance and AHCCCS. In what order should these two insurances be put in under?
2. AHCCCS
*When a patient has commercial insurance and AHCCCS, AHCCCS will ALWAYS be secondary*
Do we collect copays from patients who have Medicare Advantage Plans?
Yes! Zotec will typically bring up their Urgent Care co-pay amount. If not, check for Co-pay amount on insurance card
Zotec states amount due is $147, what amount do we collect?
Explain to patient "Estimated total is $147, would you like to pay in full today?"
If they say no, collect $75 and explain they will receive a bill for the remainder
Do we accept any 3rd Party insurance?
Example- MVA Insurance
No! Patient can use their medical insurance or self-pay
Patient has Traveler's Insurance. What is the process at check-in?
Check card/information to make sure there is a U.S. Mailing address and member ID
*Self-pay if not available*