Benefits Collection
The process that we run to receive up to date insurance information.
What is RTE?
The federal law stating that we have 3 days to notify Self-Pay patients of their estimate.
No Surprise Act.
The amount the patient pays before insurance benefits apply.
What is Deductible?
The area that we look at to see all different types of benefits listed per service.
What is Table of Contents?
The area we won't put anything in when doing Medicare Part A/B estimates.
What is Out-of-Pocket?
What we do when RTE is down
What is using our websites and calling the insurance?
This program is what we will always run to make sure that the patient still has insurance.
What is RTE?
A set amount a patient must pay before the time of service.
What is Copay?
This benefit is what we will use if they don't have any Individual benefits.
What is Family Benefits?
The percentage a Self-Pay patient will receive as a discount if they pay in full before the service.
What is 25%?
The icon that we click to open our RTE to see Table of Contents.
What is View Response History (lightning bolt)?
In the doctor's office, the codes that we must receive from our practice managers for us to bill correctly.
What is CPT codes?
The shared cost of the medical bills after the deductible has been met that is a percentage.
What is Co-Insurance?
Where we find our Deductible/Out-of-Pocket.
What is Health Benefits Plan Coverage?
This area is where we will never put a number unless the patient has one specific insurance (BCBS HealthSelect).
What is Co-Insurance Amount?
The icon that we click to get to benefits from registration.
What is Benefits Collection (umbrella).
This insurance becomes Self-Pay if they are receiving Outpatient benefits.
What is Medicare Part A?
Maximum amount a patient will pay unless otherwise stated.
What is Out-of-Pocket?
The rule that we follow when seeing if we use Individual or Family benefits.
What is whichever one is closer to being met?
This area is where we go to note, see authorization notes, and find CPT codes.
What is Referrals?
This insurance we won't make an estimate for ONLY if their referral has covered/auth number.
VA
The statement we say after we notify the Self-Pay patient of the cost and have come to an agreement.
What is "I have now created the estimate and finalized it. This is the estimated portion due before the time of service. I will now mail you a paper copy for your records"?
The rate that Shannon agrees on with an insurance that allows us to give services at a lower cost.
What is Contractual Rate?
What we click on when we need to see specifically what the benefit covers.
What is drop-down box/double arrows?
The two areas where we will note our estimates notes.
What is Comments section and Communications section?