Insurance & Eligibility
This term refers to the amount a patient pays before insurance starts covering costs.
What is a deductible?
HIPAA stands for this.
What is Health Insurance Portability and Accountability Act?
This document is signed by patients to confirm understanding of services and costs.
What is consent form?
This term refers to the amount a patient pays for each visit.
What is a copay?
Greeting patients warmly is an example of this.
What is excellent customer service?
The process of confirming a patient’s coverage before services are rendered.
What is insurance verification?
Sharing patient information without consent violates this principle.
What is patient confidentiality?
Collecting accurate demographic information helps prevent this issue.
What is duplicate medical records?
Offering payment plans is part of this role.
What is financial counseling?
Reducing wait times improves this metric.
What is patient satisfaction?
This type of insurance covers individuals over 65 or with certain disabilities
What is Medicare?
True or False: You can discuss patient details in a public hallway.
What is False?
The first step in scheduling an appointment.
What is obtaining patient information?
This federal program assists low-income patients with healthcare costs.
What is Medicaid?
Providing clear instructions for next steps helps reduce this.
What is patient confusion?
In EPIC, this verification status should be used when RTE is down or not enabled; it routes the account to a WQ yet still allows check-in.
What is 'Needs Review'?
To encrypt an email containing PHI that’s going outside the organization, you must include this word in the subject line.
What is 'secure'?
For Medicare patients, completing this questionnaire during registration helps determine whether Medicare is primary or secondary.
What is the Medicare Secondary Payer Questionnaire (MSPQ)?
This federal rule requires offering Good Faith Estimates to self-pay/uninsured patients prior to scheduled services.
What is the No Surprises Act?
Per SOP, performing this step during registration supports accurate identity verification and reduces rework and patient frustration later.
What is scanning the patient’s ID and insurance cards?
When EPIC returns an E-Verified Secondary Payer warning, this action should be taken to ensure the correct primary coverage is billed.
What is update the filing order so the true primary is first?
Per policy, PHI must never appear here in an email—regardless of the recipient or encryption.
What is the email subject line?
An ABN may be issued only under these conditions—and never for Medicare Advantage members.
What is when medical necessity isn’t met per NCD/LCD for a traditional Medicare beneficiary?
When accepting card payments at the front desk, associates must follow this compliance standard to protect cardholder data.
What is PCI compliance?
According to HFMA training resources, improving this area of revenue cycle transparency can directly boost patient satisfaction.
What is price transparency?