MEDICARE
ORDER POLICIES FOR AN ENCOUNTER
SF PAYER PLAN
SF NAVIGATION
INSURANCE BASICS
100
This is the Soarian Worklist that captures encounters when the MSPQ is incomplete.
What is the 'Missing MSPQ' Worklist?
100
This is the correct order of policies when presented with the following: Age: 55 Years Old Reason for Encounter: Slip & Fall Insurance Cards: Medicare A/B & Aetna HMO
What is Workers Com/Workers Comp, Aetna HMO & Medicare A/B
100

This is the SF Payer Plan used for a CCHS employees

What is Blue Cross/ BCBS ChristianaCare

100
The tabs at the top of the 'Patient Demographics' page performs this action when clicked.
What is scroll to the sections within the Patient Demographic page.
100
This is required for HMO patients who want to see a specialist
What is Referral
200
This is the message included with each Medicare Advantage plan.
What is the 'Do NOT add Traditional Medicare coverage/plan codes with this plan'
200
This is the correct order of policies when presented with the following: Age: 66 Years Old Self Employed: 2 employees working for the company Insurance Cards: Medicare A/B & BCBS of Delaware
What is Medicare A/B & BCBS of Delaware
200
This is the SF Payer Plan used for a State of Delaware employee presenting with an Aetna PPO plan
What is Aetna/Aetna SOD PPO
200
This is the section within the 'Patient Demographics' page where the PCP is added
What is Care Providers
200
When a patient presents with an insurance care that lists two different insurance company logos, this is the clue that will help you identify the company providing coverage.
What is Larger Logo & the INET
300
This is the number of employees a company employs. This number makes Medicare the primary payer for patients under 65 years of age.
What is under 100 employees
300
This is the correct order of policies when presented with the following: Age: 64 Years Old Employer: Wawa Insurance Cards: Medicare A/B, Coventry HMO & AARP
What is Coventry HMO, Medicare A/B & AARP
300
This is the SF Payer plan used for a patient presenting with a BCBS plan that has the following Member ID# R68884530
What is the Federal BCBS Plan
300
This is the bottom tab/page where you can add the Attending physician to the encounter
What is Summary Tab & the Encounters Details Tab
300
These plans require completion of the MSPQ
What is Traditional Medicare
400
These are the payers you would allocate to an encounter if presented with the following insurance cards: 1) Medicare A/B 2) Aetna Golden Choice 3) AARP
What is Aetna Golden Choice & AARP
400
This is the correct order of policies when presented with the following: Age: 67 Years Old Employer: Concord Music Store (11 employees) Reason for Encounter: Back pain due to auto accident Insurance Cards: Medicare A & Aetna PPO
What is Auto, Medicare A & Aetna PPO
400
This is the SF Payer plan used for a patient presenting with a Highmark BCBS card that has the following ID#: XHD1234567898
What is Health Options/Health Options
400
This is the last step taken when adding a telephone number
What is Click 'Add/Update'
400
This additional # is required when you create a Medicare Advantage plan to an encounter.
What is MHIC#
500
These are the policies you would allocate to an encounter for the following scenario: 66 years old, working for ShopRite, presents with: 1) Cigna Health Springs 2) Medicare A 3) Health Options
What is Cigna Health Springs & Health Options
500
This is the correct order of policies when presented with the following: Age: 49 Years Old Unemployed: Disabled Insurance Cards: Medicare A/B, UHC Dual Complete & Health Options
What is UHC Dual Complete & Health Options
500
This is the SF Payer plan used for a patient presenting with the following ID card: 1) Champion Health Insurance
What is Commercial Misc/Commercial Misc
500
These are the pieces of information needed to effectively search for a patient
What is Last Name, First Name, Gender & DOB
500
This is the system used to verify insurance for Medicaid
What is DMES or Soarian HDX
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