Company Basics
The founder of our company.
Who is Bill Borne?
A health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
What is Medicare?
Care that is offered regardless of race, gender, nationality, sexual orientation, and ability to pay.
What is Hospice?
I review write off's, conduct payor audits to ensure billing/collection flags are correct, enter helpdesk tickets for the teams to assist with Relay, HCHB and Managed Care requests, and review of several reports.
Who is an Analyst?
If I wanted to look up contracts I would refer to this department.
What is Managed Care?
The "S" in our Values of SPIRIT
What is Service?
A fixed dollar amount during the benefit period - usually a year (could be January through December but can also be any other 12 month period) - that an insured person pays before the insurer starts to make payments for covered medical services.
What is a deductible?
Inpatient level of care that provides families a temporary reprieve from caregiving duties.
What is respite?
Occurs when a home health agency sees a patient 4 or fewer total visits.
What is a LUPA?
I can look here for the latest updates from our CEO.
What is the CEO Corner on Yammer?
Our Chief Operating Officer.
Who is Chris Gerard?
When reviewing the Update Pending Auth with Actual Auth task, it is confirmed with the payor that authorization is still pending; don't flip out, you will update the pending program with this process.
What is Flip the Program?
Services provided in the home rather than institutional settings for individuals needing assistance with Activities of Daily Living such as bathing, dressing, toileting, ambulation, or feeding or Instrumental Activities of Daily Living such as meal prep and shopping.
What are Personal Care Services?
This occurs twice per day; once at 8am CST and again at 2pm CST.
What is manual claims billing?
If I wanted to find a list of TIN's I would look here.
What is Regulatory's Care Center list or 10c?
This was the year in which our company was founded.
What is 1982?
I should only receive Self or Other where I am located.
What is Insured Party Information?
The Notice of Election has to be dropped to Medicare within this many days.
What are 5 days?
Incentive payments made through the Medicare Electronic Health Record (EHR) Incentive Program are subject to the mandatory reductions in federal spending, required by the Budget Control Act of 2011, known as this.
What is 2% sequestration?
The link where I can obtain additional Technical Training such as Excel, Powerpoint, Outlook, and WebEx.
Our CEO attended Oxford University where he held this prestigious recognition.
What is a Rhodes Scholar?
K13 Kennewick, WA has a blanket used during this special time.
What is approval for all OON referrals?
MD testimony that a patient's life expectancy is 6 months or less?
What is Certificate of Terminal Illness (CTI)?
Major overhaul to PPS payment system that relies on clinical characteristics to place patients into meaningful payment categories.
What is Patient-Driven Groupings Model (PDGM)?
If I wanted more information from HCHB on PDGM, I could look here.