Escalating Accts
What is the activity code used to escalate an acct when an itemized bill has rev code 230 present?
IRIB
What service is HTY?
Hand Therapy
281014
Medicaid HMO Allowance Code
OCSSREP
PROCESS
What holiday decorations stayed up in our unit for almost 1 year?
St. Patrick's Days
Revenue code mismatch gets escalated to what team?
CDM
What is the letter # for Ins inactive on dos?
145
261040
Healthfirst Capitation Code
STROIKWL
WORKLIST
What gift did Josseline hide under the chair for White Elephant?
Fondue
What is the Single Case Agreement Activity Code?
RSCA
How do you reactivate an account?
F15(Shift F3) & enter
The account will be activated the next day.
If There is no F15 on the bottom right-hand side of the act then:
Type "PAAR" on line pF16 D/E enter
265017
INSURANCE BILL UNTIMELY Allowance code
TEIBFNE
BENEFIT
What was Annie referring to when she said she wanted a beer?
Hiring Abir
Name 3 Carc codes that automatically qualifies the acct to D&A
55 IP and OP Procedure/treatment/drug deemed experimental investigational by payer
249 IP Readmission
39 IP Service denied at time of auth request
50 IP Non-Covered, Not Medically Necessary
58 IP Invalid place of Service
197 IP Lack of Authorization
198 IP Authorization Exceeded
210 IP payment adjusted - authorization untimely 233 IP Charges related to a HAC
243 IP Services not Authorized
284 IP Auth # does not appply to this service
285 IP Appeal procedures not followed
286 IP Appeal time limits not met
302 IP Auth time limit has expired
Where do you check if a 28r was applied?
F2, F6, Enter
268052
Untimely to Follow Up
AIMENEL
MELANIE
How many total tickets has Isabel (Nicoles Daughter) received?
WHAT ACCOUNTS ARE EXEMPT FROM QUALIFYING TO MED METRIX (not plan codes)
- Accts that are with JOC, REV INT, CDM, Credit accounts
- Accounts where there is a COV/ELIG CARC/RARC category code posted
- Accounts that have not been referred to Clinical Engagement
What is DA vs DFY
DA: DX on Admission
DFY: Primary DX that was billed on the claim
260067
Small Balance W/O
UISACNENR
INSURANCE
What did Nicole run over this week?
A Turkey :(