Momentum
How do we bill traditional MCR?
Insurance/Bill Needed -> Insurance Follow up -> Bill Medicare
How do we know if the acct is a 501R acct?
Click on the number by facility info and if there is a "Y" by non-profit we read it.
When must we read the TCPA speech?
When the phone number is greyed out or when a call is transferred over from the TCPA dept.
Can VA and Medicare be billed together?
No MCR including MCR Advantage plans cannot be billed with VA. It is one or the other.
What is the Erequest for FAA review?
CS05
How do we update an address?
Click on the house -> put in new address -> hit save.
What phase lets us know the acct is in collections?
HCPrimary or HCSecondary
How do you notate an acct that has been sent over for QOC revew?
QOC file regarding dr.
QOC filed over care received
QOC filed due to surgery
ETC.
What do we do if a GN calls in to advise COB has been updated?
If the insurance is traditional MCR send over to have rebilled and advise COB updated.
All other ins the GN need to have the ins reprocess the claim and call us back with who they spoke to and how long it will take to reprocess the claim.
If they have already spoke to the ins go to ins bill needed -> claim pending -> Claim in process from dropdown -> document the acct: "CS TT XX VH/DEMO RETURNING CALL. COB WAS UPDATED WITH INS ON MM/DD/YY. INS IS REPROCESSING. INS ADVSD IT WILL TAKE X DAYS TO REPROCESS."
CS09
Where do we look to see if the GN has multiple accounts merged together?
ACCT Summary tab
What tab shows us linked accounts?
Links
Do you give us permission to contact you on your cell phone using an auto dialing system, text messages or pre-recorded voice on your account for future inquiries?
What information is needed to bill traditional MCR?
Caller is stating they should not be charged the ambulance transport. What is the erequest we send for review?
CS04
When do we file a media threat?
This Option should only be used if the caller is THREATENING to or has already made a negative post on social media (Facebook, X (formerly Twitter), News, etc) platform.
An Incident Report MUST be completed.
What Erequest is sent for EOB review?
It depends on what ins EOB is needing to be reviewed. CS01 is government ins EOB review and CS02 is all other EOB review.
How does a GN receive documentation if the have atty representation?
How do we know that an insurance is OON (Out of Network)
Financial Class is 05 and there is no C/A applied.
CS10
How do we hold an acct for HASP review?
Unit Routing HASP Inquiry
What is the Erequest to send an account over for HASP review?
CS36
What are the steps when completing a Privacy Concern?
Correspondence Received in Error
Speech (must be stated verbatim):
Do you attest or can you confirm that the information was not shared, copied, or disclosed to any other party?
Account Actions:
If the GN calls in and advises they cannot have any insurance or discounts on the account and they need the full balance applied as pr due to religious reasons, what erequest do we use?
CS03 and advise due to religious reasons the GN cannot have any insurance or discounts and the entire balance needs to be applied as pr.
The GN calls in and says that the coding is not correct and we check Onbase and no coding is listed, what is the erequest that we send for coding review?
CS11