EIQ
In EIQ where do add an appeal?
What is the "Denials tab"
For champ VA what is the timely filling limit?
What is 1 year from DOS
What billed from time frame should we escalate to the provider rep if no remit or payment has been received?
What is 40 days from billed date
What is the policy number for Accounts Receivable: Account Note Documentation?
What is 1749
What tab do we use to update an appeal sent?
What is the "Denials Tab"
What is the timely for Kaiser Colorado
What is 90 days from DOS
Do we still call the payer if the claim is billed over 40 days with no remit or payment before escalating the account?
What is yes, we should still follow up on the account.
In a note is the phrase " Next action call payer again to check status on the account claim/appeal status due to delay in processing, payer asked to allow additional time" acceptable?
What is No, we need to ask questions to verify why there is a delay and advise the payer per contract this is over the contracted time frame, over all dig into the reason and push for processing.
In EIQ where can "Value Codes" be located?
What is the 837 claims tab # 5.
Name payers availity can provide claim status and or eligibility on?
What is-
Who adds provider escalated tags to EIQ once provider escalation is in place?
What is leadership.
Should AR follow up place "All" past history in a note if an account is from 2023 or just a summary of key details effecting the current claim issue?
A short summary including Key detail. ex. dates, denial reason, rebill reason, should not include multiple dates of calls or conversations with payer.
What time frame must action logs be verified once received and marked completed by the requestee?
What is 2 days
What payer has this Appeals address Attn: Appeals and Grievances Unit P.O. Box 31364 Salt Lake City, UT 84131-0364"
What is-
"UnitedHealthcare Community Plan"
When an account is provider escalated do we add them to the trend log?
What is No
Can we include threshold amounts in notes?
What is No, need to say efforts exhausted.
True or False-We dont have to use the note template in EIQ for AR when working PDFU spread sheets?
What is-False, we do have to use the note template
What payers are not affected by the NSA(no surprise act) law?
These Plan Types DO NOT Fall Under the NSA:
Medicare/Medicare Advantage/Medicaid/Managed Medicaid/Tricare
Third Party Liability Coverage (Auto, Workers’ Compensation, etc.) Policy # 7525
What Question would we ask the payer if they tell us they need more time for processing?
What is- why is there a delay on the normal time frame and is this issue effecting multiple claims? Can I speak to a leader to verify what claims are affected as this can also result in interest owed if not paid in the contracted time frame. Note: multiple answers can be accepted for this question.
What next steps would you take on an account that is $25,000 that has been noted with the same note for 3 months that the payer is non-compliant, won't call back, has no portal or cannot provide any claim denial information/EOB or reason for delay and has no provider rep.
Multiple answers-looking for, send a letter to the payer address from EIQ to start, contact leadership after the second touch with no movement.