Private Eyes
These should be generated and printed at the center on the 20th of each month.
What are private collection letters?
What process must be used when a UB-04 or HCFA 1500 billing form is received from a vendor?
What is consolidated billing?
AR balances start hitting bad debt when they hit this bucket.
What is 180 days?
This should be used to determine the next steps when collecting on an account?
What is the private collections timeline?
This will trigger PCC to create a Medicare copy claims when selected.
What is the Medicare Advantage radio button?
A meeting should be held with a new resident or RP within these many business hours?
What is 72?
What process should be used to move a credit from one bucket to another?
What is an AR Transfer adjustment?
These two payers don't hurt your bad debt as much when written off.
What are Medicare A Coins from Medicaid (A4) and Medicare A Coins from Private (MAP)?
Private pay payments are due to the center by what date each month?
The 10th.
What Medicare status indicates that the resident cannot be billed for copays/deductibles?
What is QMB status?
This should be done after every interaction with a resident or RP regarding their account?
What is document in PCC?
Federal BC covers Medicare A Coinsurance for this many days.
What is 30?
We can never do a write off of this payer.
What is Medicaid Pending?
What form of payment will get credited the same day?
What three situations require a new authorization for Highmark BCBS episodic payers
What are admission, transfer in and the start of a new episode?
You should do this when mailing collection letter 3.
What is call the resident to notify them that the account is being referred to collections?
This should be reviewed weekly to make sure payers did not terminate.
What is the PCC Eligibility Dashboard?
Private accounts great than this amount can be referred to the collection agency.
What is $500?
These two forms must be completed to submit an application for SSA Representative Payee.
What are an SSA-11 and an SSA-787?
If a resident readmits under Medicare after a 3+ day LOA, this box must be checked in the census setup.
What is "Reset MDS Billing Calendar"?
This should be done in the Power BI Collections Dashboard to make sure that every account has been collected?
What is drill down?
This must be done in Triple Check when a Highmark BCBS Episodic claim extends into the new month.
What is transfer the entry from the first month to the second month?
DSO stands for this.
What is Days Sales Outstanding?
The administrator can approve this as a final ditch effort to collect on a private account?
What is offer a settlement or payment plan?
This report must be run for all new Medicaid-related payer admissions?
What is PROMISe eligibility or PROMISe EVS?