IVF
These payer types do NOT need an IVF
A patient is missing an IVF in vision.
What is Missing Insurance Verification
This spreadsheet is where you document communication with private pay patients
What is the Private Pay Spreadsheet
Who is Victor!
The payer table shows patient has Optum, after doing the IVF you find the patient also has a $25 copay and no COB.
What is add in the Copay Funding Coverage in the payer table and send the Copay Welcome Letter
This is where you complete the IVF
What is
Patient's current primary denial expires 11/15/24, we are currently waiting for payer to mail us the denial letter that will be effective 11/16/24
What is Waiting for Primary Denial
This is where the HCA can be found in vision.
What is the attachments table!
These types of Blueshield plans need to be sent straight to Blueshield
What are FEP and Shared Advantage!
Patient's payer table is filled out with primary insurance information, but theres no record of an eligibility attachment uploaded.
What is upload a screenshot of the eligibility from payers portal to vision (attachments table)
This person is responsible for completing the IVF
Who is the RS/biller!
The branch emails me saying a new patient will have a SCA under WellCare, but it is not yet finalized.
What is Pending Rate Agreement-SCA
This is where you can find BCBA's credentialing status
What is the BCBA Credentialing Listing!
This person bills Tricare
Who is the RS!
What is email the branch asking if they can confirm patients correct DOB with family.
This is the tab where you initiate the IVF (be specific)
What is Clinical->Assessments Tab in Vision!
Patient is Private Pay Monthly, but there is nothing uploaded in the attachments table
What is Missing Homecare Agreement
Where do you find the patients Primary Care Physician? (be specific)
In vision at the top right where it says "PCP"!
You should notify these two people if you have a new ChampVA patient
Who are Candise Mcdonald and Michael Pierre!
Patient is missing a PCP in Vision
What is email branch asking to enter in a PCP and verify credentialing once entered.
After checking the BCBA Credentialing Listing, BCBA Jane Doe shows no effective date and there's no fill color for Evernorth.
What is Worker not yet Credentialed with Payer
This is where you can find a patients service authorization.
What is the patients census page in the attachments table and/or the Service Authorizations table!
Who sends families Tricare Copay/Co-Insurance Letters?
Who is the biller/RS!
You should set this up when a patient has a blanket denial from the primary insurance that IS accepted by the secondary insurance.
What is Payer of Last Resort