TOOLS
File from client containing RSi-assigned accounts and high level demographic/insurance information regarding the client
Placement File
Maximum dollar amount in which payment is based for covered health care services. What the payor says they will consider out of the submitted line item charges (total charges).
Allowed Benefit
TRUE or FALSE:
An email must be:
* Long
* Professional
* Hard to Read
FALSE.
An email must be Concise, Easy to Read and Professional.
The code used when the claim has been denied for any reason other than no authorization.
DND
Clicking anywhere within this box will display account balance information.
Balance Info
The process by which a patient or provider attempts to persuade an insurance payor to pay for more (or, in certain cases, pay for any) of a medical claim.
Appeal
TRUE or FALSE.
We should ensure that the name of an attachment is descriptive and accurate.
TRUE.
ACT
Latitude screen where a collector updates a file.
Account Work Form
It is the approval of care, such as hospitalization, by an insurer or health plan. This is requested before the patient is treated. (This number must be present on the claim forms and is not a guarantee of payment).
Authorization
What should be displayed on the Subject Line?
* Specific
* Descriptive
The abbreviation "CO" stands for ________.
Comment Only
Area to enter Action/Result codes and paste Hot Note Box comment.
New Note Panel
The identification of the nature of an illness or other problem by examination of the symptoms.
Diagnosis
YES or NO.
Should you send an email to your Supervisor to inform the action that you took to resolve a denial?
NO.
Status Code used when records have been requested by the insurance and the rep is awaiting records to be sent to them from Client.
REC
Internal to RSi only and should not be utilized to search client systems.
File Number
The statement provided by the Health Insurance Plan after claim processing documenting the submitted services/procedures associated charges, allowed amount of charges, patient's deductible/co-insurance and payments made by the plan as well as any denied item(s) by the plan. (also referred to as a Remittance Advice).
Explanation of Benefits
YES or NO.
Should you include the Patient's demographics when sending an email to your Supervisor?
NO.
Status code utilized when collector is allowed to make the adjustment in Client's system.
CAN