General
Name the VOI payors
What are VOI1, VOI2, VOI3, AUTHVOI1, and MEDIVOI1
This is where you upload insurance cards for MGL
What is the PMF
VOI1 means
What is needing to verify insurance information on the account.
VOI2 means
What is that we need the patient primary insurance information
VOI3 means
What is the patient needs to update their coordination of benefits (COB)
First step to take before updating primary insurance payor
Steps that should be taken when tasking the insurance RS on an account
What is adding the TASKRSRVW activity code to your note (with follow up complete checked), adding the TASKRS override under the insurance payor that needs review, and flipping the balance to the insurance payor that needs to be reviewed
Steps taken when updating the primary insurance payor
What is reversing any adjustments on the account, removing the old insurance info, removing the VOI and other patient payors, and adding new insurance information (Insurance RS does not need to be tasked)
Information needed to resolve a VOI2
What is primary insurance information
VOI3s can be resolved by
What is the patient contacting their insurance provider to update their coordination of benefits
Information needed to verify insurance
What is insurance name, group ID, member/subscriber ID, plan ID, medical claim address or EDI/payor #, and primary policy holder info
This is the action taken if the secondary insurance generates a prior auth hold
What is add NATB under the authorization # section (on the secondary insurance)
Steps if just the subscriber ID needs to be updated
What is flipping the account back to the insurance payor, removing any VOI or patient payors, and adding the TASKRS override for the claim to be resubmitted
What is FnlRptd
Steps taken once a patient calls back and notifies us they updated their COB with insurance
The action that is needed if the insurance matches what we have on file
What is asking the patient to email in a copy of the front and back of their insurance card
You can check if a claim has been queued for submission here
What is the Correspondence section of the History Log in Xifin
This is helpful to add before and after the Payor Name when searching for an insurance payor in Xifin
What is *
Action that is taken if a patient states the insurance we have on file is their primary insurance
What is advising the patient to contact their insurance provider to update their coordination of benefits
If provided, an easy way to search insurance is
What is with the Payor ID/EDI number or claim address on the back of the insurance card
This needs to be added if the DOS is past 60 days
What is NATB to the Authorization # section
This is what you do after adding secondary insurance to an account
What is reversing any non-EOB adjustments (cost estimate, FAP, promise, hardship) and then flip the balance to the new secondary payor. If the primary fully denied, add back the full original balance
This is what is added to the Payor ID section when searching for an insurance in Xifin
What is WH*, ARX*, or MGL*
This is the activity code used when updated insurance and the insurance RS does not need to be tasked
What is NRPINS - NRP - Insurance or UPDT - UPDT - Updated Information
When would the insurance team need to be tasked on accounts that have updated insurance
What is if only the subscriber ID was updated, the insurance information is correct (the patient has called insurance to verify), or the patient has updated COB issues