CONSENT
FORMS
FORMS
This general consent form goes over giving the hospital permission to treat, blood testing, and to bill the patient's insurance on their behalf.
WHAT IS COA/ CONSENT OF ADMISSION?
The patient had an injury at work. What would we list as insurance?
(2 answers needed)
MISC WC or WC PRISM.
We will also list health insurance if they have it.
When checking in patients who come via ambulance we use this to write down the patient's name, dob, ssn, and where they came from.
What are the EMS Point of Origin sheets?
The application we use in the emergency department to check in patients and view the ED flowboard.
WHAT IS FIRSTNET?
This site allows us to access our emails, look up SOPs, and clock in.
FORUM
The form needed when a patient is being admitted to the hospital as Inpatient and they have Medicare.
Goes over patients right to be involved in any decisions made about their hospital stay and how to appeal a discharge.
What is IMM/ Immediate Message from Medicare.
What insurance would we list if the patient was in an auto accident?
If they have their auto insurance information with them, we would list their auto insurance information and and health insurance if they have any.
If the auto insurance is unknown or incomplete, list the patient as self-pay.
How long should registration take?
25 mins.
5/ 10/ 20
Where you go to scan, register patient, patient accounting and open nurses' units/ bed board.
PM OFFICE
We need to look at our emails every day with this application
What is outlook?
The form needed when a patient is being admitted to the hospital as observation and they have Medicare.
Goes over what Medicare will cover during their stay.
What is a MOON/ Medicare Outpatient Observation Notice?
What information do we need when a patient has been injured/ had an accident?
Date, Time, State, and accident details.
Who do we call if we need to call in or if we have any questions our team can't answer?
What are Team Leads, Supervisors, and Managers?
What is Capacity Management?
We use this website to send link to patients.
What is Phreesia?
The form needed when a patient is being admitted to the hospital as Inpatient and they have Tricare.
Goes over patients right to be involved in any decisions made about their hospital stay and how to appeal a discharge.
What is IMT/ Important Message from Tricare?
The patient had an accident at work.
We would list __ _____ if the employer was listed on the _____ ____.
What is WC Prism and Prism List?
AIDET
ACKNOWLEDGE, INTRODUCE, DURATION, EXPLAIN, THANK.
The application we utilize to look up patients. It does not show any confidential patients.
What is revenue Cycle?
We use this application to communicate with our team and GBS.
What is Teams?
What is required on a verbal consent form?
If the patient is in police custody/ incarcerated and has insurance, what would we list?
If the patient did not have insurance, what would we list for their insurance?
Their Health insurance.
If they were in WPD custody, we would list Wichita Police Custody. If they were in sheriff's custody or incarcerated, we would list Incarcerated.
This questionnaire ensures that we list Medicare in the correct order to be billed.
What is MSPQ?
If you are not sure about the who pays first, you can also verify on CSNAP.
What is Powerchart?
We utilize this to print out any forms (IMM/ MOON/ COA/ BSBS, ETC.
What is Access Passport/ EFR?