PATOS
Easy Pay/Mock Adjudication
Open Invoice
Past Due
Self Pay
100

What does PATOS stand for?

Payment At Time Of Service 

100

What is Easy Pay?


EZ pay is the opportunity for patients to pre-authorize payment for the estimated balance of their visit after insurance has been billed. 

100

What is Open Invoice?

A balance owed from a previous encounter. 

100

What is Past Due?

A balance owed from a previous visit that has gone unpaid by the patient. Patient was sent multiple invoices over a 3-month period. 

100

What is Self-Pay?

Patients that do not have insurance and must pay for testing at the time of service. 

200

Should you ask the patient "Would you like to take care of this today?  

NO ask the patient "How would you like to take of this today". 

Do NOT give the option to not pay but the option how to pay. 

200

What is Mock Adjudication?


A patient responsibility that is determined by the insurance in real time. It is an exact amount the patient is responsible for. 

200

What are forms of payments that are not accepted to be used to make a payment on an invoice?

Cash, Checks and Money Orders.

200

What should occur if the patient states they are unable to pay for the whole amount on the invoice?

Print the invoice and instruct the patient to call Billing. Inform the patient we will not be able to provide service until payment is received. 

200

What forms of payments do we accept?

Payment Methods are MC, VISA, AMEX, Discover, Prepaid Cards, FSA and HSA. 

300

What is the benefit to collecting payments from patients?

Collecting payments help reduce bad debt and INCREASE our yearly bonus. 

300

What prompts Mock Adjudication in Quanum ?


Insurance driven.  Quanum is connected to the insurance that will inform us of the patient's responsibility. 

300

Are we able to invoke the turn away policy if a patient is unwilling to pay for an Open Invoice?

No because it is a current invoice and not a Past Due invoice.

300

Do we invoke the turn away policy at PSCs and IOPs?

No, we invoke the turn away policy at PSCs only not IOPs.

300

What is entered into the insurance carrier field when patient requests financial assistance?

Indigent Patient 

400

What is the required capture rate for every PSR for Easy Pay?

PSC 65.7%

IOP 41.6 %

400

What prompts Easy Pay?

Insurance driven. The correct insurance ID and group number (if applicable).

400

What should you do if the patient has any questions concerning their invoice?

Print the invoice and direct the patient to call the Billing Customer Service number located on the invoice.

400

How many times has a patient received an invoice before the invoice because Past Due and what is the cost for each mailing?

3 times with a cost of $1.54 for each mailing.

400

What is UPP?

Uninsured Patient Pricing are discounted up to 40-50% off list price on most tests given to patients.

Patient will present with a requisition that is stamped with the UPP stamp or UPP is noted in the comment field on a Hold Order. 

500

How much $$$ did we lose last year mailing invoices to patients?

$5,583,778.20
500

Is it optional to ask a patient for Easy Pay or Mock Adjudication?


NO, it is the responsibility of the PSR to ask when Quanum prompts to ask for patient responsibility.

500

What should occur if the patient states it was billed to the wrong insurance?

Update the insurance on the invoice pop-up. Click on "update insurance " if the insurance in the "insurance name sections " is incorrect.

500

Name 3 exceptions for the turn away policy.

  • Government insurance (system determined )
  • Blueprint for Wellness (system determined)
  • Employer Solutions (system determined)
  • Client bill order (system determined)
  • Quest Direct (system determined)
  • Pediatric patient , 5 years of age or less (system determined)
  • Drop off specimens by a medical professional or when patient is not present
  • STAT order
  • Recollection patient
500

What is entered in the insurance ID field for Indigent Patients?

Fin Asst

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