Sliding Fee Scale
A patient is SFDP approved, what do you select for the bill and payer type?
Client Pay
Ms. Jones is self-pay. Her provider ordered in-house test, and a few send-out test. Which test would the patient have to pay for, if any?
All test
You have CCHCI established patient Mr. Garcia come in w/ outside orders, he has private insurance. Do we have the him pay up front for the specimen handling and venipuncture?
No, his insurance will cover the fees.
You have a question about your scheduled labs, do you seek help from the PSR, MSSS, or your supervisor?
Your supervisor
The provider wants to send a Urinalysis and a FIT screen which one of these tests cannot be sent out?
Both test
You have a prompt pay patient, the provider ordered an SFDP approved test and a non approved test. Would the patient pay for one of the test or both?
They would have to pay for both test, because they are both send out test.
The patient has commercial insurance, Title X, and WWHCG. Who do we bill to, and who is the payer in order of priority?
Always choose commercial insurance
A patient has not been seen since 2020, and brings in an outside order. They do not have insurance. What is the process for drawing the patient?
You cannot draw the patient, they are no longer established.
You have 6 patient's one with SFDP, one with Title x, one has WWHCG, another has ACCHS, self-pay, and the last has prompt pay. None of them can afford to pay for their labs. Which one (or more) of these patients is eligible for CCHCI Care Funds?
all except ACCHS
The provider ordered an in-house test on a prompt pay patient, it has been more than 7 days since the provider placed the order. Can the patient still have the lab work completed?
Yes, they have to pay.
Are ACCHS and Medicare commercial and/or private insurance?
They are neither—ACCHS is state issued and Medicare is federal issued.
You get a recall notice on a test kit you received a year ago. Where can you look to see if you had that lot number during that time frame?
Check you inventory log.
A patient has Title X and SFDP. The following test and test codes have been ordered, which test are NOT approved: CBC 0028124, HIV 083935, HG A1C 001453, HCV 144050
CBC 0028124
You have two patients one is self-pay and the other is prompt pay. Which one is eligible for our client fee discount?
Both are eligible. As long as they pay up front and sign the required our forms.
A patient has Mercy Care the provider ordered a test, but they forgot to select which entity it is going to. Can you fix the order and which reference lab is it going to?
Yes, the lab specimen will go to Sonora Quest
What percentage of your call back logs, requisition logs, and patient logs do you think we will be auditing?
100%