Coverage Verification
This electronic system is the first resource we use to verify insurance
What is EEVE?
This group name is used for Prepaid Medical assistance plans
what is PMAP
This person or entity is ultimately responsible for any unpaid balance after insurance pays.
What is Guarantor
Minnesota follows this type of auto insurance system
What is No fault?
What is Primary Care?
After EEVE and Payor websites, this is the final verification method if needed.
What are phone calls to payors?
This program combines Medicare and Medical Assistance benefits into a single plan.
What is MSHO
Filing order determines which of these gets billed first
What is an insurance/coverage
This coverage type applies to injuries that occur while working
What is Work Comp?
If only percentage values are listed in EEVE and no dollar amount, the copay will be entered as this amount.
What is $0?
When no coverage can be found after all searches are completed, the account should be marked this way.
What is Self-pay
This type of employment plan requires you to call and verify benefits per the EEVE response
What are Union plans
Patients may remain covered under a parent's insurance until this age.
What is 26?
APC stands for this financial assistance program
What is Allina Partners Care?
This department type requires review of the Mental Health Provider-Outpatient section.
What are Mental Health/Psychology or Psychiatry visits?
This verification status overrules Network Limitations when both apply.
What is limited benefits?
What does the abbreviation MHCP stand for
What is Minnesota Health Care Programs
These two pieces of subscriber information are required before adding coverage
This is used in the work queue to route an account to the specialty team
What is *S?
The standard prepayment for an uninsured/self-pay patient is this amount.
What is $100?
For future dates of service (not within the current month) with Medicaid, encounter should be deferred until this day.
What is the first day of the month?
These plans act as a Replacement for Professional billing and a supplement for Hospital Billing
What are Cost plans
CBT works at this level when reviewing guarantors and coverages
What is the encounter level?
When working an account with APC or MES what is required to verify the coverage and NOT route to specialty team
What is Primary coverage?
These patient's and/or visits do not require a $100 prepay when uninsured
What are newborns/nurse visits/faith based/PEI?