Column 1
True or False: When sending a patient an outstanding balance statement, it is important to insure that the outstanding balance is in the medical aid column.
False
True or False: Momentum and Health Saver Remittances can be processed via ERA.
False
Name the two types of statements that can be sent to a patient.
An Outstanding Balance Statement
A No balance Statement
What action is required before requesting an assistant to be loaded on Goodx?
To check if the assistant is already loaded.
When is linking applicable?
When procedure codes were correctly billed, but a code(s) needed to be added to the service date. (Payment already received, reverse invoice, Link original payment to correct invoice resubmitted and wait for rest of codes to be processed/paid)
When rates were billed incorrect (Reinvoice & Resubmit with correct rates and link money already received, wait for rest to be processed and receipt accordingly)
When modifier not applied for example modifier 0005. (Funds like Discovery will apply modifier 0005 on their side and pay accordingly. Credit your incorrect invoice where modifier was not applied, rebill invoice and apply modifier 0005, Link their payment to your new invoice and follow Dr’s billing rules going forward)
When receipting via ERA, which two fields needs to be updated?
What is the checks you do on the EDI Report?
All Switch Responses (Status Columns)
If there are any rejections, amend and resubmit
PMB Flagging per Service Centre (In rooms, In Hospital – Flagged or Not)
Resolve ONLY ONCE SUCCESSFULLY ACTIONED
Goodx Email Templates - What information should be inserted in the free text format?
Name
Surname
(Email Address)
What steps to follow when processing a Medicol Payment?
Reverse XP Journal/s
Process payment
Process third parties collectors fee journal
Write off remaining balance on invoice
Explain the steps of the Zero Day Process
1. Does the Coding match the Service Centre
2. Are the rates indicated on the invoice correct?
3. Is it a PMB condition that should be flagged?
4. Are All Claims successfully Submitted Via EDI
5. Move Account as Per Movement Policy