Core Value
Motivates teammates to show empathy for patients, Handles patients escalation with care
We Put Patients First:
Team Leaders
What is a Contractual Allowance?
The amount the provider agrees to take as a discount.
How many steps in Cerner to add insurance before the Re-Sequencing?
Five Steps
Before escalating a caller, the Customer Service Representative (CSR) should first attempt to?
(CSR) should first attempt to de-escalate the call. Successful de-escalation can lead to better one-call resolution and often can help resolve the caller’s issue faster.
What does Analyzing an account means?
Analyzing an Account is the act of applying all of your skills to answer questions about the account and determine what steps need to be taken next.
Father of a 18 year old patient calls in to discuss the son's account without permission. What direct violation of the core value if any patient information is disclosed?
Core Value: Safety and Privacy (Age of Majority Protocol) Example: A patient turns 18 on November 29, 2025. A parent calls regarding the account on December 1, 2025. Even if the parent’s name remains visible in the system from prior visits, disclosure is strictly prohibited until the patient provides updated, post-adult consent.
What is a Deductible?
Amount patient must pay before insurance coverage begins (starts to make payment).
How many steps is it to Email Ib's for Cerner?
13 Steps
If CSR is unable to de-escalate caller, What is the next step.
Then call should be forwarded via a warm transfer (meaning the CSR transfers the call to the next level and introduces the caller and explains the situation) to next level up (Team Lead, CSR Point) via whichever escalation forwarding method is most appropriate for the situation.
In order to know exactly what is being worked on, on an account you will need to do what?
"Thoroughly read the notes!!!!!"
Acts with integrity and transparency
Provides good judgement and relies on
the good judgement of others
We Work as a Team: Teammate
What is a Co-insurance and give an example?
A percentage amount between the patient and insurance.
Insurance % of charges and patient pays % of charges
80/20
90/10
70/30
How many steps are there to pull up the IB Queue?
Six Steps
When notating the account, CSRs should document What?
The source of caller frustration and their solution in as much detail as possible. It is just as important to capture what the caller wants as much as what was done on the call. This can reduce caller frustration if further calls are needed.
What are the five types of notes on an account?
Collector notes
Artiva Alerts
System Notes
Front end notes
BARRT Notes
Strives to bring out the best in our teams.
services, and business
We never settle: Senior Leaders
What is Out of Pocket Maximum?
The maximum amount the patient has to pay under their insurance policy. Covered services above this limit paid at 100% by the insurance company.
Application is used to access patient encounters to determine if they have previous balances and look up any other details of their encounters. It is used for billing.
Cerner Revenue Cycle
Escalations may be forwarded in any of the following
Direct Transfer - Calls should be warm-transferred to the next supervisor or management level.
– Email - Issues will be forwarded via an email that captures the caller’s contact information (i.e. name, contact information, patient information) and information summarizing the complaint or issues and the escalation / actions taken thus far. A template providing guidance for email escalation requirements is recommended.
– Voicemail - Calls will be warm-transferred to the voicemail of the next level (warm transfer means the caller is told they are being transferred to a mailbox, not a live person).
When doing a Deep Dive on an account there are eight important things to pay attention to ,What are they?
Read the notes Thoroughly
Is a payment posted?
Review the Remit
Were total Charges processed?
Is the contractual posted Correctly
Does the patient owe the balance?
Is the payer requesting additional information?
Are there non –covered or denied charges?
We are curious, creative, innovative and
always looking for ways to improve the
healthcare experience. What Core value is this?
We Lead the Way
What does the UB in UB-04 stands for?
Also what is that form also known as?
“Uniform Billing” also known as the Form CMS-1450
lists of accounts the user may be assigned to work on.
Today’s Expected Arrivals is one example. It allows the user to have a list on the screen of all scheduled patients coming to the hospital today.
Worklist
If the Team Lead / CSR point is unable to resolve the caller’s issue, What is the next step?
Then call is forwarded to next higher level (i.e. supervisor / manager) via whichever escalation forwarding method is most appropriate for the situation.
When analyzing the account what are the eight quick glance areas?
Account age
Facility
Total Charges
Account balance
Financial Class
Current Payer
Phase and Status
Service codes