General Expectations
Something supervisors expect you to attempt before requesting a transfer / sup callback.
What is de-escalating?
The meaning of a CO-49 denial.
What is non-covered charges?
The HIPAA verification process.
What is asking caller for the patient's first name, last name, DOB and if they are the patient / their name and relation to the patient?
The properties we need to include in the subject line of each email.
What is LOB, Accession #, and Reason for Escalation?
The TM who loves sweets and sugary treats.
Who is Mary?
390 seconds.
What is our AHT goal?
The OA100, PR100, PI100 denial meaning.
Team to report PHI / PCI exposure calls to.
What is Valor management team?
The team we send follow-ups to regarding concerns about PR confirmation and insurance denials.
Who is RS?
The TM who got promoted within 6 months.
Who is TM Ashley?
Something we should add to every accession we touch/discuss, including when we attempt callbacks and are not able to reach the patient.
What is leaving documentation?
The meaning of PR-22 or CO-22 denials.
What is Covered by another payor per COB?
A caller calls in to report they are receiving text messages for another patient they do not know. These are the proper steps to handle it.
What is removing the caller's phone number from the system and notating account to state the phone number was removed and for what reason?
The team we send to when we need help getting a claim sent to insurance.
Who is FE/EP?
The Health & Fitness TM.
Who is Anida?
The action all agents must take if they receive a test call from anyone other than a Valor team member (Britt, Alexa, Mike, Julissa, Roxy, Demi, etc.)
What is report to the management team?
The section we should be checking if we see that an insurance is on file but did not process or it errored out.
What is the Eligibility Transactions?
Steps we need to take if the patient's DOB is incorrect.
What is checking req forms if the DOB is correct on them, checking for other accessions, and requesting a government issued ID if neither options are available?
The team we send to in order to locate Faxes.
Who is SR Agents?
The TM who is a big reader.
Who is Michele?
The action every agent must take on QA and coaching forms and department updates.
What is acknowledging them?
The information we do NOT need from patients who are military members / veterans.
What is DOD number?
Steps to take to authorize callers who are not the patient but are requesting PHI.
What is ask if the patient is available, confirming patient's name and DOB and that they are the patient, asking if we are authorized to discuss and update the accession with them, and if they would like it to be a one-time or permanent consent. Then notating the patient demographics page if they say it is a permanent consent so future agents know.
The team we send to for legal threats, W9s being faxed, disputes due to lab errors, etc.
Who is XiFin Management?
The TM who will be a traditionally published author one day.
Who is Kristine?