The "General" Insurance
Don't try to go out of network, unless its an emergency with this plan. You better have a referral to see a specialist
What is HMO?
You should never see these in a person's registration or put them there or its an error?
What is comma,hyphen, or periods?
The only medicare part we bill for?
What is outpatient, Medicare part b?
A medical bill by any other name.
What is EOB?
explain co-pay
what is the small fee you pay for prescriptions or expected prior to service when you arrive to the doctors office?
You better not call Tyrone if a representative from the correctional facility is calling regarding an inmate. Instead immediately call
What is Barbara Johnnson the IDOC scheduling coordinator
If you don't remember to uncheck the box here you put your check in danger?
What is Message pool?
Amanda has good Aetna through her husband, blue cross through her spouse.
what is BCBS, PRIMARY & Aetna secondary
POS simply stands for & means.
What is Point of service plan Similar to an HMO, need referral but can step out of network for additional costs
You better pay this every month or you will lose your private insurance.
what is premium?
What is workman's comp?
When completing the registration my DOB says I was born in 83. The guarantor should be set as this.
What is self?
Call Center Manager Yesenia just got insurance through CLH, but still has straight medicaid. Coordinate & explain why.
what is CLH insurance, primary & then medicaid secondary because medicaid pays last?
MCP stands for & means.
What is a Managed care Plan, which is a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs.
Explain deductible.
what you are expected to pay before insurance kicks in?
The MCP's in order from least to most restrictive.
What is PPO EPO POS HMO?
Daily Double: Amanda has aetna PPO & BCBS COMMUNITY. This is what determines who pays first and second in registration.
What is COB?
Daily double: I retired three months ago, but I still got my insurance. I already got my medicare part A set up and I need to go get my flu shot. Coordinate.
what is your retiree insurance. Medicare Part A is not paying for no outpatient?
THE DAILY DOUBLE: HIB stands for this and simply means this
What is hospital insurance benefits, medicare part A. Medicare insurance for inpatient
THE DAILY DOUBLE: Explain co-insurance.
norm 80%, 20% but based on policy & is the percentage you are expected to pay when you get the bill for a covered service
the daily double: Put the MCP's in order from most to least restrictive.
What is HMO POS EPO PPO?
UI's slogan regarding billing?
What is Bill once & get paid?
Individual is age 65 or older, is covered by a GHP through current employment or spouse’s current employment AND the employer has less than 20 employees:
What is MEDICARE is primary. GHP secondary.
SMIB
What is supplementary medicare insurance benefits, medicare part b, outpatient benefits
TPO
what is Treatment, payment, healthcare operations. Treatment encompasses the care we provide to the patient. Payment includes billing and collection activities. Healthcare operations include all of our business activities, including teaching and training healthcare professionals. These are reasons why healthcare staff can share PHI w/o violating HIPAA?