Insurance
Your patient presents you with Medicare as well as Tenncare secondary. When loading the B payer you would select _____ as the payer and use patients ____ as the ID number.
What is Medicaid, SSN?
Quick group check on Optum indicates submission is required. Evaluation is completed and your next step is to submit a ____ _____ online.
What is clinical submission?
If more time is needed when working a group open task a _______ ______ should to be requested.
What is date extension?
You are scheduling a re-evaluation for a workers compensation patient. You will use ____.
What is RW?
During live registration of a ASPP patient you must print an ____ ____ _____ _____ and collect ____ dollars for the initial evaluation.
What is Advanced Self-Pay Pricing Waiver; 110?
When scheduling a commercial UHC patient it is important that you obtain the _____ _____ and complete a ___ ____ ___ on the ____ site.
What is group number; quick group check; Optum?
When One Call provides continued authorization it is imperative to check the ____ ____ visits as they often reduce the visits based off ______ visits from previous authorization.
What is total approved; remaining?
The case record houses important information. When loading a WC case some additional pieces of information must be entered. There are ____, _______, _______, and ___ ____ ____.
What is DOI, Work related Y/N, Auth/claim #, and progress report tracking?
You are scheduling a Dry Needling only evaluation for a patient. Your appointment type would be ____.
What is ECDN?
This is the timeline you use in attempts of obtaining a signed POC since the initial electronic fax.
What is 7; 10 (day19); 7 (day26)?
Your patient presents you with BCBS as well as Tricare for Life secondary. When adding the appointment it is important that you note in the comment section ___ only due to ___ ___ ____ being secondary.
What is PT, Tricare for Life
WC patient has used all of the approved visits. CM calls you and provides additional sessions over the phone. You will use the ___ ____ form to build your authorization. You will follow up with ____, if necessary to ensure they have record of these newly approved sessions.
What is verbal authorization; TPA?
There are 3 types of tasks within Raintree. These include ______, ______ and _____ _____ _____.
What is POC, AR and Work Comp Documentation?
You have a potential patient come in who has BCBS and is wanting to schedule an appointment without an MD referral. You are not able to schedule them. True or False?
What is False?
You have a patient who is wanting to start our Skilled Training program, but is wondering about pricing. You educate them that it will be ___ dollars for ___ minutes and ___dollars for ___ minutes.
What is $45; 30; $90; 60?
You have a WC patient that is DOL. You schedule the patient and request authorization on the ____ site for each possible ____ ____ that will be used. Remember these are in ______ and should be at least _ months out.
What is DOL, CPT code, units, 2?
A BlueAdvantage patient has completed an evaluation and you schedule them for 12 sessions. For authorization, you will ____ for initial ____ within ___ ____. However, after the initial visits you will need to ____ in the _____ ____ _____ form.
What is call, visits, 24 hours, fax, additional visits request?
Patient has received a DME item and they have Medicare as their health plan. You are Medicare Bonded so you will load an ____ payer in the insurance line up to ensure appropriate billing.
What is F payer?
Your patient is a initial skilled training patient. You will use ____.
What is ECST?
During ABN review the therapist determines continued care is medically necessary. At this point ___ approval will be requested and ABN will _____ be signed.
What is KX and not?
You have a patient who agrees to a set copay per visit and to setup a monthly payment plan with the BO. It is important that you educate them that the ______ at each ____ does not go toward the _____ ____, they are separate. However, both ______ go toward satisfying the patient's ______ ________.
What is payment, visit, payment plan, payments, financial responsibility?
An Amerigroup patient has completed an evaluation and you schedule them for 12 sessions. You will submit the authorization request within ___ ____. Your next step is to ____ ____ _____ into ______ under ______ ______. You will follow up to confirm request was received with in _____ _____.
What is 24 hours, scan fax confirmation; documents; auth request; 24 hours?
You received a medical records request from an attorney's office via mail. What is the process you need to take?
What is scan paperwork and envelope (where they can see the post marked date) into patients chart and Fax/Email paperwork to Medical Records?
You are scheduling a workers compensation patient for an initial evaluation for wound care. You will use ____ as the appointment type.
What is EWNO?
When setting up a Skilled Training account it does not require a ____ ____ . When setting up the insurance you will load it in as a __ ____, using _____ as the code and then _____ it to the corresponding _____.
What is MD Script; P Payor; 00001; linking; case?