PSR Scripting
Difference that is billed after the visit, if the insurance does not cover the visit.
$299
Routine Medical check as a courtesy. What are the steps and what happens when the vitals are out of normal range?
Courtesy Vital check.
PSR register the patient as a nurse visit at no charge. If the vitals are outside normal range, register patient as a illness visit.
Who is eligible for the employee and family UC visits?
•All WellStreet employees (full-time, part-time, PRN).
•Employee’s Immediate family members (Immediate family is limited to spouse/domestic partner and dependent children until the age of 26).
1.Note: The team member discount does not apply to the team members’ extended family such as parents, in laws, aunts, brothers, cousins, sisters, uncles, and grandchildren.
•Temporary agency employees are ineligible for this benefit.
Free Employee Visit
•Covers Hep B, TB, Flu, MMR, Varicella, and COVID-19 Vaccine. This benefit also covers COVID, Strep and Flu related visits in addition to COVID 19 and Flu antigen test.
•If a patient presents for any of the above reasons, but a different diagnosis is given by the provider after the examination, the employee will need to re-register and pay the $50 employee visit.
2.$50 Employee Visit
•Covers all services (including imaging, stitches, and in house labs, and PCR Covid 19)
•Center dispensed medications ARE NOT covered in the $50 Employee Visit.
oStandard self-pay price for ALL medications will apply and will be collected upon check-out.
•Send out/outside labs ARE NOT covered in the $50 Employee Visit.
oLab will bill patient directly for MI, OH, and SC centers.
oGA will collect additional fees at time of service based on self-pay pricing sheet.
Usually starts with a U
Ambetter
Amount due before insurance covers the visit. What is the scripting?
Deductible. “Hi Mr./Mrs. ________, we verified your insurance benefits and see that you have a deductible with your insurance plan that hasn’t been met yet. You have $_____ remaining for the calendar year. We will collect $100 toward your deductible today and put a card on file for any remaining costs your insurance deems patient responsibility.”
What is VA CCN? When do you collect the UCERN number?
Veterans Insurance.
You collect the UCERN number every visit by calling 888-901-6609
Doors open and close at what time?
7:50am and 8:00pm
Has three letters before the member ID
Blue Cross Blue Shield
What is Easy Pay and its scripting?
Easy Pay (EP) allows our patients to save their card to PatientCo to pay for any remaining balance after their insurance pays their contracted rate.
“I see that you have/have not signed our Easy Pay consent form.
With our Easy Pay option, there will be no charge on your card today. However, there will be a $25 authorization amount to ensure the account is active. This amount will be returned to your account in 1-5 days. After your insurance has been processed and has paid your claim, any remaining balance will be charged to the card. This amount will not exceed the limit of $299. Any amount over $299 will be billed to you. As a courtesy, we will email you 3 days prior to processing any payment to inform you of the amount that will be charged. Which card would you like to use for our Easy Pay system?”
Regardless of who the mail is addressed to who collects/opens mail?
PSRs and it should be opened the same day to determine the purpose and send to the appropriate department.
Internet is down
Use downtime forms
Starts with the number 7
Amerigroup
What are the highlights to Easy Pay? Who is exempt?
Highlights
• An EP is required for every visit.
• An authorization amount of $25 will show as pending on the cardholder’s account. This is to ensure the account is active.
• For families with 3 or more patients, the PSRs will only authorize EP for 2 members, with the max authorization amount capping at $50 ($25 per person).
• The max amount the card can be charged is $299.
• The patient will receive email notification 3 days prior to being charged.
• The card will expire after 180 days.
Who is exempt?
• Patients with a Copay
• Self-Pay.
• Workers Compensation.
• All Medicare plans.
• Veterans Administration/VA insurance.
• All Medicaid plans.
• Medical Emergencies.
• Exceptions as approved by PM or ACOD.
What is the recheck policy?
UC:
•Patients have 3 days for a recheck visit to be no charge. (This includes symptomatic covid patients)
•All return visits after the 3-day time, will be considered a new visit and all charges pertain.
•Exception is procedure/wound care visits – policy below
Procedures/Wound care:
•Patients have up to 14 days for a recheck visit to be no charge.
•Anything after 14 days will be a new visit.
-If the patient had their sutures placed at any of the WellStreet Urgent Care clinics, there is no charge.
-If a patient has sutures placed by another facility outside of our clinics, the patient can choose to file with insurance, or be self-pay and pay for the visit.
Under 18 visits can happen when?
If the patient is coming in for STD testing
If the patient is coming in with an authorized guardian that is above 18.
If you don't call you can not complete the registration.
VA CCN
Amount of money that is owed by the patient from the previous visit. What is it and the scripting?
Bad Debt.
Scripting
“Mr./Mrs. _____ I noticed that you have a bad debt balance with us. The balance is $________. How would you like to take care of that today? We accept credit, debit, HSA, and FSA
Amount remaining before the insurance pays. What is this called and what are the two options?
Remaining Deductible.
1. Collect Easy Pay (EP) for the patients visit. (Refer to Easy Pay SWI)
2.
Pay towards remaining deductible
•
If the patient declines EP and has a REMAINING DEDUCTIBLE of $210 or greater, you will collect $210 for the visit.
•
If the patient declines EP and has a REMAINING DEDUCTIBLE of less than $210, you will collect the entire remaining balance.
o
I.E. If the remaining deductible for an individual is $85.54, that is that amount you will collect at the time of service. (TOS)
Can only replace Medicare if the card has MedicareRx
Replacement plans