D815
If unable to locate coverage and passport does not display other active coverage, what process do we need to follow?
Uninsured Process
Passport shows active coverage for a Medicare Supplement and unable to confirm primary insurance, the note should be:
PLS REVIEW PASSPORT SHOWS MEDICARE SUPPLEMENT, UNABLE TO VERIFY PRIMARY INSURANCE
If notation shows point of origin D, admit source D, or if service code shows BH, PSYCH, GERI, GERO, or if the iplan shows Behavioral/BH.OR PSY, the note should be:
PLS REVIEW PSYCH ACCOUNT
Which queue we should send an account that final destination is showing "Closed"?
MSC queue
If meditech/expanse shows REG for charge account, the note should be:
MEDITECH/EXPANSE SHOWS REG, WILL CLOSE FOR ACCOUNT TO PROCESS
If unable to locate the iplan in Meditech/Expanse, and select the closest iplan, the note should be:
UPDATED IPLAN TO (add iplan), NOT ABLE TO LOCATE SPECIFC IPLAN PER PASSPORT RESPONSE AND ADDED MBI FROM WPS WEBSITE/PASSPORT/ONBASE
What we should do if passport shows Medicare Rehab and Medicare A and B active?
We would remove Medicare Rehab from Meditech and leave Medicare A and B only if response shows active for Part A and Part B
If a facesheet shows Status IN, Priority NB, Service NSY, Admit Date 10/11/2025 and DOB 10/11/2025, the note should be:
PLS REVIEW NEWBORN ACCOUNT
In addition to reviewing REV.ABN docs in OnBase, which other document should be reviewed?
Rev.Other Folder Documents
If determined a credit is listed and meditech/Expanse does not list a future date of service (account doesn’t pull up in Meditech/Expanse or shows as canceled) and no prompt pay discount is listed, which queue should we send the account?
Refunds/Overs Payment Resolution SSC Queue
If passport is already verified, and an iplan is needing to be removed but not updated, what note should we use?
ACCT PREVIOUSLY WORKED, WILL CLOSE TO ALLOW ACCT TO PROCESS
If the date of service is greater than 30 days, which note should we use?
PLS REVIEW DOS GREATER THAN 30 DAYS
If a facesheet shows Status: ER, Priority: EM, Service: EME, Admit Source: PR and Reason for visit: MVA, the ADM SRC AND ADM TYPE should be:
1 - 5
What should be done if we find a note indicating ABN on file is non-readable?
Notate and escalate to PTAC Reports Team Vendor Escalations
For credit accounts, what would be the correct format for the date in the note if Meditech/Expanse shows a future date of service?
SUBMITTED C LINE FOR (YYYYMMDD)
In Passport, we have a single Medicare Replacement tab, we go to Expanse and see that the replacement is already added, but the ID is incorrect, so we need to update it, the note should be:
Verified/Confirmed IPLAN via Passport, updated in Expanse
If Medicare Iplan listed in Meditech/Expanse is not valid, the correct note should be:
UPDATED IPLAN TO (add iplan) PER PASSPORT RESPONSE AND ADDED MBI FROM WPS WEBSITE/PASSPORT/ONBASE
If a facesheet shows Status: ER, Priority: UR, Service: ERS and Reason for visit: Back pain, the ADM SRC AND ADM TYPE should be:
1 - 2
Mention at least 5 required pieces of information for an ABN to be valid
Patient name / pt acct # / description of ordered services / estimated cost of services / option 1 or 2 must be checked / signature of patient or representative / 2 witnesses if patient refuses to sign / date of signature (black or blue ONLY)
If the account type is determined to be SDC, INO, IN or ER, the note should be:
ACCOUNT TYPE IS (ADD ACCOUNT TYPE), OUT OF SCOPE
The MBI needs to be added to the patient ID for...
Traditional Medicare and Medicare Replacement Iplans. If the passport response shows the Medicare Replacement and the MBI is not included , the team does not have to search for it.
What we should do if the passport response shows Medicare Reference Lab?
The team will review the service code. If service code shows REF the team will use that iplan. If the service code does not show REF, the team will use the traditional Medicare iplan.
If note shows specific admission/type and Host reflect the same information or after review of the Facesheet , the account is determined to be valid in host, the note should be:
Host already shows the ADM TYPE/ADM SRC
If an account does not clearly display inpatient or outpatient, the note should be:
PLS REVIEW, UNABLE TO DETERMINE ACCT TYPE
If an account is sent back from BI and the notes say “submitted l line/charges transferred/moved charges/removed charges”, the note should be:
PER BI NOTES, WILL CLOSE TO ALLOW LINES TO PROCESS