Customer Service
Call center, referral management, authorization, clinical staff, epic systems.
Who are customers to the patient access department?
Health Insurance Portability and Accountability Act
What is HIPAA?
Person who is responsible for registering, scheduling, and obtaining demographics to include insurance.
What is Patient Access or who is an RAS?
MD who can provide you a referral for specialty services
What is a PCP/Gatekeeper?
Low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI) are examples of mandatory eligibility groups for this coverage.
5 step communication tool used to provide excellent customer service
What is Aidet?
Name, Address, Phone Number, SSN, MRN, etc.
What is PHI?
Registration times, pcp information, collection rate, hospital account creating
What are KPI Metrics?
Determines if Medicare is primary payer.
What is MSP?
Helps cover the gaps for coverage.
What is a Medicare Gap plan aka Medicare Supplemental?
Attitude, Interest, Actions, Verbal Language, Body Language, and Tone of Voice
What are the 6 Pillars of Customer Service?
The fraudulent practice of sending emails or other messages purporting to be from reputable companies in order to induce individuals to reveal personal information, such as passwords and valuable information.
What is Phishing?
Healthcare software that is used throughout UHS.
What is EPIC?
Person who applies for the insurance plan
HMO, PPO, POS, EPO
What is the types of commercial insurance plans?
Consistently meeting customers’ expectations
What is customer service?
Announcement of Joint Commission Visit
What is Code Purple?
Name, DOB, SSN, and Phone Number
What are the 4 patient identifiers?
Determines who is primary when patient has two insurance policies.
What is COB?
Plan that includes Part A, B, and D
What is a Medicare Advantage Plan?
Empathy, Problem solving, communication, active listening, patience, adaptability, positive attitude
What are the 7 traits to excellent customer service?
Locking your computer when stepping away, throwing PHI papers in the Hipaa bin, turning your compter away from other patients when registering.
What is ways to be HIPPA compliant?
This is where you can find tipsheets for each department.
What is Patient Access Learning Home?
Person responsible for bill on patient account.
Federal health insurance program that provides health benefits to Americans who are age 65, disabled, End Stage Renal Disease or ALS.
What is Medicare?