Patient Payment Options
Discount offered when Patient amount due is Paid in Full
What is a Prompt Pay Discount
Place where you go for non-complex injury or illness
What is Urgent Care
Information sent from the insurance company after they have processed the claim
Explanation of Benefits (EOB)
Part of the Revenue Cycle that includes gathering patient information while they are at the facility
What is Registration?
Collects patient information and registers encounters across the facility
Who is a Patient Access Representative (PAR)
Program for patients that qualify based on a sliding scale and the Federal Poverty Guidelines
What is Financial Assistance?
Department open 24/7 for complex illness or injury
What is the Emergency Department
Denial resulting from insurance companies believing the procedure or service didn't need to be done.
What is Not Medically Necessary (NMN)?
This is the part of the Revenue Cycle where information in the patient chart is utilized to add or update charges and add diagnosis codes.
What is Coding?
Works with insurance companies to insure appropriate claim coverage and payment
Who is an Insurance Biller
App/Website where Patient's can go and see test results, appointment reminders and other Medical Record Documentation
What is Patient Connect?
Certified healthcare facility designed to increase access to outpatient primary and preventive care in underserved, non-urbanized areas.
What is a Rural Health Clinic (RHC)
COB stands for what to the insurance company
What is Coordination of Benefits?
Part of Revenue Cycle where claims are submitted to insurance companies for payment
What is Billing?
Works with families of Extend Care residents in all financial processes
Program provided by a contracted hospital partner to allow patients to extend the time needed to pay bill over months or years
What is a loan program?
Small, rural Hospital providing 24/7 emergency care with 25 or fewer beds and more than 35 miles from any other hospital
What is a Critical Access Hospital (CAH)?
Liability insurance covers what
What are automobile or home/property accidents?
Part of Revenue cycle where Insurance or patient Payments are processed and applied to encounters
What is Posting and Reconciliation
Employee who attempts to get authorization from insurance companies
Who is the PAL, Patient Advocacy Liaison
Pieces of this program include Good Faith Estimate, Shoppable Services and a Machine-Readable list of Hospital Charges
What is Price Transparency?
Place of service where you are most likely in need of a pre-authorization
What is Radiology (MRI or CT)?
Bill type are Hospital services billed to insurance on, both professional and technical
What are UB 04 and HCFA 1500?
Part of Revenue cycle where denials or errors are received, reviewed, work and/or appealed.
What is denial management?
Audits and manages the chargemaster