General Business Office
How often should Medicaid Pending cases have billing notes added in Visual with active follow-up?
What is weekly.
Preferably any additional conversations or updates, need to be added to billing notes at the time of conversation.
Who is responsible for completing the Therapy Funding Verification forms?
What is the BOM
What is the difference between a Copay and Coinsurance?
What is a copayment is a fixed dollar amount you pay for a covered healthcare service, while coinsurance is a percentage of the cost for a covered healthcare service.
What day are cash projections, and MCD Billing completed each week?
What is Thursday
What documents are required to be sent on the 10th and 25th of each month?
What are Collection Letters on the 10th and 25th as well as Resident Statements on the 25th.
How long do you have to complete a Therapy Funding Verification form?
What is 24 Hours. Preferably the same day or less than 24 hours.
What does COB stand for in regard to Health Insurance?
Per the AR Calendar, when do you need to begin reviewing/uploading the current week's MCD RA to Visual to post? And what Date do we post the MCD RAs each week?
What is Monday to have them entered into Visual and they must be posted the date the MCD RA is deposited into the bank.
What is the last business day Insurance/Managed claims must be released?
What is the 6th Business Day
What documents need to be attached to the Therapy Funding Verification Form before returning to the DOR?
What is the CWF. Preferably the CWF from NGS.
What is call the insurance company and check benefits for part A, B and any coinsurance benefits.
What items are due on/around the 15th of each month?
What is the RFMS Reconciliation and Mid-Month Cash Review.
When a resident D/C from the facility, no return anticipated, how long do we have to issue a refund check from their RFMS account?
What is 5 days. We have 30 days to issue a refund if the resident expires
True or False: Only the current payer needs to be circled on the Therapy Funding Verification form and nothing else.
What is False
What does the Part's of Medicare Stand for and cover?
What is:
A- Hospital Insurance / SNF Insurance
B- Physician / Outpatient/Anc Insurance
C- Managed Care
D- Prescription Drug Coverage
What are 2 tasks need to be completed daily per the AR Calendar?
What is Deposit and Post Cash, as well as KLOCS/LOC and LOI Review daily.
Regarding RFMS, what is the guarantee called that has to be kept on file and up to date each year?
What is the Surety Bond.
True or False: The BOM must read, understand and circle the correct payer on the Therapy Funding Verification form as well as provide the Member ID, DOB and insurance phone number or fax to request any Prior Auth's as needed.
What is True
Many Health Insurance policies require the patient to pay an initial amount of their own bill before the insurance plan will reimburse anything. What is this amount called?
What is Deductible.
Per the AR Calendar, when are you required to send your Facility PMA report to your RFA?
What is MEC day 2.