HEALTHCARE
COB
What is Coordination of Benefits
Funded by Federal Govt for those 65+, Railroad Employees, w/Endstage Renal Disease or permanent disability
What is Medicare
Requires PCP, Referral, In-Network provider
What is an HMO (Health Maintenance Organization)
Three components/cords of quality Healthcare
What is Safety, Clinical Effectiveness and Patient Experience
What is eRAD RIS
Explanation of Benefits statement to INSURED
Partially funded by govt but mostly be State for those w/lower income
What is Medicaid
Does not require PCP or referral but must be in network
What is EPO (Exclusive Provider Organization)
Name three components of a positive patient experience
What are timely appts, easy access, report turnaround, excellent CS, respectful and responsive staff, communication, compassion, error-free billing, accountability
Translates written notes to procedure & diagnosis codes
What is 3M/CodeRyte
Explanation of Benefits statement to PROVIDER
What is a Remittance Advice
Funded, provided and administered by non-governmental entities
What is Commercial Health Insurance
Requires PCP, Referral, In Network Provider and allows Out of Network Provider
What is POS (Point of Service)
Three components for a healthy organization's "Life Blood"
What is Satisfaction, Loyalty and Retention
RadNet's Revenue Cycle Management billing system
Issued by PCP for patient to see a specialist
What is a REFFERAL
Covers medical costs associated with auto related injuries
What is Auto/No Fault Insurance
What is a PPO (Preferred Provider Organization)
Clearinghouse used by RadNet to consolidate & manage claims
What is Availity Essentials Pro
Issued by payer, giving provider approval for service
California claims are sent to these groups rather than health insurance
What is a Medical Group or IPA
Plan that is held and funded by a company for its employees
What is ASO (Administrative Services Only )
According to a recent survey, this % of customers do not trust adverts
96%
Houses all RadNet Remits and Payments
Medistreams