Root Causes
We would need to demonstrate the contracted agreement and rates for this issue.
What is short payment/contract issue?
This is the balance minimum that is typically required for an account to be eligible for attorney placement.
What is $5,000.00?
Typically, if the insurance is in review for this, then we will not move forward with an attorney placement.
What is a Known Payer Issue?
What are authorization issues?
What is Status Code 522?
Leadership will use this status code to approve an attorney placement request and forward to the CFO for their approval.
What is status code 524?
We would need to provide a detailed timeline of events, including a reason for delays, and possibly any exclusions or exceptions to allow this type of attorney placement.
What is a timely filing exception?
Adding an account to this worklist, which is a log of accounts that are placed on alert to inform the facility of current account status, will often require updating when requesting an attorney placement.
What is the Action Item Log (AIL)?
The controller will use this status code for final approval of an attorney placement request, which will reroute the account back to the BSO for placement with the law office.
What is status code 521?
We would need to demonstrate the chain of liability and eligibility for this type of placement.
This Activity Code is used for attorney placement request.
What is A/C 367?
This BSO Team compiles all the needed documentation, confirms the necessary approvals, and places the account with the outside attorney.
What is the Audit Team?
This occurs if a payer denies our claim and advises that we are not in network with their plan, but where we can provide policy exceptions, authorization, and/or a one time agreement that allowed us to provide care.
What is an OON Provider?
What are COBI issues?
An email or approval from RDMC or Team Leadership must be scanned into IPScan when an account still has this level of payer issue code active.
What is the level 4 PIC?