Admitting & Registration
The person ultimately responsible for paying the patient's bill
What is a Guarantor?
What services are covered by Medicare Part A?
Abrasion
Scrape on skin
QMB
Qualified Medicare Beneficiary
What do we use to determine the spelling/format of a patient's name?
Photo ID
Who can provide consent for a patient?
Spouse, POA, Conservator, parents of children under 18
What should you use for a VA policy number?
The patient's SSN
Epistaxis
IMM
Important Message from Medicare
Who should be listed as the attending/referring providers on an outpatient order?
The ordering provider
When do we use the DNOS field?
To add information for a provider not in the system.
What is a deductible?
A fixed sum that a beneficiary must contribute towards the cost of their health care before insurance benefits begin
Hypertension
High blood pressure
HIPAA
Health Insurance Portability and Accountability Act
What can we not process an outpatient order without?
What act allows patients to be seen in the ED with no insurance coverage?
What is the difference between Medicare and Medicare Advantage?
Medicare Advantage is a Medicare replacement plan managed by a commercial company
Syncope
NPI
National Provider Identifier
What are the most common examples of patient identifiers for PHI? Pick 2.
Name and DOB, SSN, address and phone number
What are the MSP questions used to determine?
Medicare as a secondary payer
What is an out-of-pocket maximum?
The maximum dollar amount a patient can spend in deductible, co-pays, and co-insurances before the plan pays everything.
Cholecystectomy
Surgery to remove the gallbladder
JCAHCO
Joint Commission on Accreditation of Health Care Organizations
What is the purpose of an Advanced Beneficiary Notice?
To make a patient aware of noncovered services through their insurance