Insurance verification
What is insurance verification?
Insurance Verification is the process of confirming a patient’s active health insurance coverage and understanding the benefits they are entitled to before medical services are provided.
What is PAR ?
Prior Authorization
Appointment scheduling is crucial in managing patient flow in healthcare settings
What is calendar management?
Process of organizing appointments, meetings, tasks in a calendar to avoid conflicts and ensure efficient use of time
Au is the chemical symbol for?
Gold
What includes the insurance verification?
*Policy is active and valid
*Identifying what services are covered under the patient’s plan
*
Determining the patient’s financial responsibilities such as co-pays, deductibles, and coinsurance
Verifying if the provider is in-network or if referrals or prior authorizations are required
-PRECERTIFICACION-PRIOR APROVAL
-TAR-TREATMENT AUT REQU
-SAR-SERVICE AUT REQ
scheduling appointments helps to:
allocate resources, reduce overcrowding, minimize wait times, and ultimately enhance patient satisfaction.
What is double booking?
two appointments are scheduled for the same time and physician in the calendar
Who is TBO CEO?
TODD USHER
Mention the insurance plans
HMO
PPO
EPO
Mention the PAR types
-INICIAL : NEW ORDER-NEW REQUEST
-RENEWAL : REQUESTION THE CONTINUAL TREATMENT
-RETRO : FOLLOWING UP AFTER THE ITEM HAS BEEN DISPENSED-DELIVERED
Mention 3 types of appointments
Routine check -ups
follow up
emergency
specialized consultation
telehealth
What are calendar reminders?
feature allows user to automatically receive alerts before a scheduled appointment
This author wrote Hamlet
William Shakespeare
EXCLUSIVE PROVIDER ORGANIZATION EPO
How it works: Similar to PPO, but no out-of-network coverage (except emergency). No referrals required.
What is the timeframe for Retro?
RETRO: 10-14 BUSINESS DAYS
Having ____________ in healthcare settings is crucial to ensure smooth operations, efficient patient care, and staff productivity
Scheduling policies
What is Practice Fusion?
Practice Fusion is a cloud-based electronic health record (EHR) platform designed for independent and small medical practices. Founded in 2005 and headquartered in San Francisco, it became the most widely used cloud EHR in the U.S., supporting thousands of practices and managing millions of patient records.
In what year did the Berlin wall fall?
1989
What is POS, and how does it work?
POINT OF SERVICE
How it works:
Hybrid of HMO and PPO. PCP required for referrals, but patients can go out-of-network for higher costs.
What happens when authorization is not obtained prior to deliver?
Claims are denied
What is the timeframe for a consultation?
Consultation: 30-60 minutes
What information do you need to schedule an appointment for a new patient?
Full name
DOB
Contact information
reason for visit
insurance information
Who is my fav singer?
TAYLOR SWIFT