WV
The source of truth
What is One Source?
First step
What is move the case to "working"
Tracking that PRM creates to update MC growth
What is a Opportunity?
1st check in with patient
What is a 30 day task?
When a pt. wants to switch to a different OSH provider
Who is the Practice Manager?
How Medicaid/Supplemental/Medigap plans are inserted in GWY.
What is secondary?
Proof of OSH provider or on Managed Care
What is a One Source report?
Dental, Vision, Gym membership, OTC, meals, transportation, etc.
What are Medicare Advantage benefits?
We know their happy when they're in this bucket
What's in "engaged"?
When a patient loses their Medicare card
What is Medicare?
Medical history going back 3 years
What is the Blue Button?
When a patient does not appear in adjusted membership after put into closing.
What is a Flow Through Case?
Acronym process for addressing MC patient objections
What is CANI: Clarify, Acknowledge, Neutralize, Inform
Where all pt. interactions are located
What is the activity log (log a call/create a task)
When a Dr. needs to know a drug tier
What is the formulary?
Primary Insurance
What is Medicare or Medicare Advantage?
When a patient "drops" from the adjusted membership report, this is created
What is a Dropped Case?
Proof that a pcp switch occurred.
What is a confirmation number?
When a patient needs a different plan and they are eligible to switch.
Who is the agent?
Patient needs a PA
Who is the nurse?
Medicare + Medicaid
What is dual eligible?
Billing, Complaint, Eligibility
What are cases a PRM can create?
All patients on managed care with an OSH provider
What is the Adjusted Membership Report?
All the info patients need given by the PRM in January.
What is the retention packet?
An agent doesn't show up for agent of the day.
Who is Rachel?