Bridge
The main tab we go to search for a specific account
What is Recovery Record Search
I am used when there is authorization issues
What is AUTHR
Placing priorities on claims that go OOT, Organizing your work, and introducing yourself to other analyst to use as resources
What is Follow up musts
How to find something in OneNote you're not sure where it is
What is Search field
An internal system code used to indicate what follow up or corrective action is needed based on the denial or claim status
What is action codes
What is Recovery tab
I am used when Carrier is asking for Medical Records
What is PDMR
Everything on the account is complete that can be
What is follow up is completed
Where you find the link to all your training docs
What is Pathways tab
Followed up on a first level appeal and still in review
What is DFP1
Where we go to find the EOB
What is Document tab
I am used when the procedure is one they don't cover
What is NOCO
The statement sent by the payer that covers details of provider charges, what services were paid, reason for denials ect..
What is EOB
Action codes and Reason codes information
What is the week one tab
Sending for adjustment
What is DAPA
The role of the person who owns the account
What is the handler
I am used when the client has recalled the claim OR when they have adjusted and closed Epic
What is PIE
Request letter, Ask if additional appeals are available, Ask if any par forms are needed
What is questions you would ask if reconsideration/appeal denied
Where to find Call template
What is the Making calls tab
Payment obtained but there isn't updated information they can give at this time
What is DPC
The field you'd use to find account you worked on a specific day
What is Followed Up Date Field
I am used when a new account and is sitting in our inventory waiting to be reviewed
WIPS
These codes drive payments for Inpatient claims
What is DRG codes?
Where we find who to refer the DORR process to
What is Trainings tab/who is Supervisor or lead
Sending to your trainer to review before sending to have something re mailed or faxed?
What is the DORC process