Insurance Verification
Insurance Cards
Health Insurance Terms & Definitions
Policies & Procedures
Time of Service Collections
100
Insurance verification websites (3)
What is Availity, United Healthcare and Navinet
100
Must be collected at each visit along with the drivers license
What is insurance card
100
The insurance company's written statement to a patient showing what they paid and what the patient must pay.
What is an EOB
100
The amount that should be in the cash drawer at the beginning of each shift
What is $200
100
The amount to collect when unable to verify benefits
What is $150
200
Must have to verify Tricare eligibility
What is Sponsor's SSN
200
The person who is responsible for paying the patient's bill
What is a guarantor
200
Cash, check and credit cards
What are the payment options
300
The money that an individual must pay after their deductible has been met.
What is a co-insurance
300
The discount offered to self-pay patients that must be paid in full at the time of service or within 48 hours.
What is Prompt Pay Discount
400
Medicaid program that doesn't cover ER services, only well woman/preventive care.
What is Texas Women's Health Program
400
The amount an individual must pay for health care expenses before insurance covers the cost.
What is a deductible
400
The form that is given to all Medicare patients that is used to determine the primary carrier
What is the Medicare Secondary Payer Form
400
The maximum amount to collect on deductible only plans
What is $350
500
Prior approval obtained for inpatient and/or observation admissions
What is Pre-Authorization/Pre-Certification
500
Sometimes called Part C or MA Plans
What are Medicare Advantage Plans
500
The maximum amount of money a patient pays out of their pocket for medical costs before their insurance will pay at 100% for health care
What is the out of pocket
500
The amount that should be collected from a patient with a $150 co-pay plus a 20% co-insurance.
What is $200
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