3,2,1.... HAPPY DOWNTIME!
True or False?
Downtime is tracked in case it needs to be explained later.
This can only benefit you.
How often are Monitoring Errors distributed?
Weekly
There are claims sitting on my worklist and not dropping off, can downtime be claimed for this?
No,
No downtime will not be approved for this issue as it does not affect your production.
You can send an WTI email advising of the issue so a ticket can be submitted.
What is the timely filing deadline for corrected claims?
365 days
It is your responsibility to check your Kronos for accuracy & submit a ___ for any changes that need to be made.
TRF
Can I request downtime for a lengthy (long) claim?
No downtime will be given for “long claims” because the time is already factored into your daily production.
True or False?
I never review my monitoring errors because I trust the error I've made was true.
FALSE,
You should always review all errors (monitoring errors or quality) before you agree.
How often should I check my claims on hold?
Daily.
Claims on hold should be reviewed daily so they can be finalized as soon as possible. Claims on hold are checked daily by the Supervisor and Team Lead, a follow up is required.
I can use the BY HRG saved to my computer to get pricing for the claims?
False.
The pricing rates update constantly. Please be sure you're pulling from KIP.
True or False?
Its optional to send a "What's The Issue" email?
False.
If you're experiencing any issues of any kind, you must first submit the WTI email for assistance and/or direction on the next steps to resolve your issues.
How much break time should be submitted with you Power BI entry daily?
30 minutes.
2- 15 min breaks
Can I decline coaching on repeat errors?
Yes,
Coaching is optional and can only benefit you. You can decline if you wish.
I can't get this claim to clear! Can I leave it and try it again later?
Yes!
You will need to put the claim on hold, leave a note, and add it to the "looping" tab located within the question log.
You must add your looping claims to the "looping" tab located within the question log.
What note on the authorization do you follow while working the BA hold?
The most recent note on file.
Does it matter if I send screenshots or not?
Yes!
Screenshots help development assist in correcting any Power BI or PEGA issue that you're currently having. If you're able to, please submit screenshots with your emails.
How much Administrative Minutes should be submitted with you Power BI entry daily?
30 minutes of Standard NPT
Can I request additional coaching on errors?
ABSOLUTELY!
True or False?
Is it ok for me to leave claims sitting on my worklist over the weekend?
The goal is for your worklist to be completely cleared of pending claims by the end of your work week.
If you have claims on hold, you should be sending that hold email at the end of your shift for our TL Aubrey to follow up.
Timely Filing (CHC Gen)
What would you do if the first DOS is out of timely filing but other lines are within timely filing?
Deny any lines outside of timely and then allow any lines within timely filing to pay.
When is it appropriate to send a WTI email about any issues I'm experiencing?
IMMEDIATELY.
Please, please, please send the email as soon as you're experiencing any issues in hopes to get your issue resolved as soon as possible.
True or False?
All unapproved downtime will be removed from Power BI entries followed up with an email from management to advise of the changes?
TRUE.
Any unapproved downtime will be removed from you entries and I will email you so you're aware.
I don't agree with this error, what can I do?
What are my options if I need a claim put into a T status?
1.) Add it to the question log.
You can also IM Aubrey for immediate assistance if needed.
Timely Filing (CHC Inst)
What would you do if the first DOS is out of timely filing but other lines are within timely filing?
Allow the whole claim to pay.
It goes by the discharge date.
Supervisor: Jasmine Kirkland
Team Leads: Aubrey Welschox, Christaia Richards, Michael Robinson, Jeff Estadt and (Kate) Catherine George.