Analyzing Accounts
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.
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 HMS stand for?
Hospital Management Systems.
What is the FC for Champus/Tricare
Finn Class: A
What is the Action code for Call Back
CB
In order to know exactly what is being worked on, on an account you will need to do what?
"Thoroughly read the notes!!!!!"
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.
What is HMS used for?
An HMS is a comprehensive software solution designed to manage various aspects of a hospital's operations, including patient information, scheduling, billing, inventory and more.
What is the FC for Blue Cross
Fin Class : B
What is the Action code for Patient Payment
CC
What are the five types of notes on an account?
Collector notes
Artiva Alerts
System Notes
Front end notes
BARRT Notes
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 steps to cancel a Time Pay in HMS?
Go to the Collection Follow-Up screen for the patient.
Press F15 to bring up the MONITOR Time Payment System screen.
Press F23 to delete.
Press F23 to confirm deletion
What is the FC for Blue Cross Appeal
Fin Class: BD
What is the Action code for Contact No Payment
CN
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?
Escalations may be forwarded in any of the following 3 ways
-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).
What are the steps to logging into HMS?
Sign on screen key in username and password
2)On Patient Accounting Menu key in (pass)
3)key hospital of choice name.
4)Find hosp and type 3 in front
5)Then Enter
What is the FC for Commercial
Fin Class: C
What is the Action Code for Refer Accounts to be Escalated/Reviewed
Referral
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
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.
How Many steps are there to set a Time Pay in HMS?
16
What is the FC for Workers Comp
Finn Class: E
What is the Action code for Return to SSC
RTN