Culture
Type of culture that impacts patients
What is welcoming atmosphere, warm greeting, active listening, positive interactions?
Acceptable body language and facials
Welcoming, smile, positive energy and tone
Worker's Comp definition
Worker's Comp checkpoints
What is scan the ID, confirm injury/surgery date, adjuster and NCM contact info, Authorization approval?
Verification of Benefits process
What is a courtesy to ALL patients completed 24-48 hours prior to evaluation, create an EOB and communicate with patients the financial responsibility?
PRIDE stands for...
What is Professionalism, Respect, Integrity, Development, Excellence?
Acceptable appearance
Professional, clean, approachable
3 types of Worker's Comp including color and account type.
What is state funded (pink), certified self-insured (white), and self-insured (white) all in AT 50?
Contract Tracking
What is new appointment request for patients and workers comp (PITA)?
Financial Responsibility terms and definitions (4) found on an EOB
What is Copay? Fixed/flat rate the patient pays at time of service that may or may not apply to OOP. What is Deductible? Amount a person has to pay in full BEFORE benefits kick in and the patient's COINS applies. What is COINS? shared amount that the insurance covers and the percentage the patient is responsible for. (ex: 80/20) What is OOP? The max amount the patient will pay per year, typically resulting in the patient being covered in full.
A professional email should contain....
What is kind greeting, signature with proper info, grammatically and spelled correctly, and no CAPS?
Customer service Attributes
What is Active listening, empathy and awareness of company policies and procedures throughout BSW?
Workers Comp Verification process
What is call the adjuster and complete the WC's verification form, confirm if IE and number of additional visits, if any, are approved?
Define Functional Capacity Evaluation (FCE)
What is a 4 hour long standardized test used to test one's ability to perform specific duties that may be required by their job?
Hard Max vs Soft Max
What is absolute max number of visits or dollar amount covered vs additional visits may be approved usually after review for medical necessity?
How do you communicate with outside teams such as CSO or IVO.
What is first check RMS for referrals and double check communication, and ensure patient information is included in all communication?
ICARE stands for
What is Introduce self and role, Communicate, Ask/Anticipate needs and concerns, Respond to requests, and Exit Courteously.
Authorizations for Worker's Comp?
What is contact the adjuster to request additional visits, which may take up to 72 hours for approval/denial?
Define Post Offer Employment Testing (POET)
What is an evaluation that assesses a job candidate's physical ability to perform the essential functions of a job after they've received an offer but before they've started work.
Plan year vs calendar year
What is a plan with an alternate start date vs a plan that begins January 1st?
When do you involve your ASM
What is contact your ASM first when there is an error, and allow them to communicate with management on your behalf?
Employee Recognition Programs
What is Torchbearer Nomination, Impact Awards, etc.?
Auth is approved, what's next?
What is update the insurance grid with auth number, visit number, start/end dates; add insurance comments with auth info, update health insurance auth box with additional visits and exp date, add auth approval into the chart, schedule the patient if not scheduled?
Define Work Conditioning
What is a program used to ensure employee is physically able to return to work or complete all necessary tasks within their position, typically lasting 32 hours with approval, that consists of a 2 hour eval followed by 10 3 hour appts scheduled 2-3 times per week.
BSW Payment options (4) and process
What is Charity (send to ASM approved for 6 months), Financial hardship, Copay deferral, DED/COINS payment plan, and Prompt Pay?