PARTICIPATING/ NON PARTICIPATING
Do we negotiate with insurance?
No
OSS, WOR, MVA, COM, and OSMA are all examples of
What is Global
MED
What is Medicare
What two Things do you do when you make any changes in an account
What is F1 and notate the account
What issues get reported to the enrollment database?
Issues with providers
Department that sets up contracts?
What is Enrollment
UHC, AET00, CIG00 are examples of
What is Global NEIC
Champus/Tricare
What is Champ
How do you view the diagnosis on an account
What is charge-change
What issues get reported to Reimbursement Database
What are Missing or invalid issues causing claims to reject
If not contracted with insurance then bill patient with remaining balance
What is Balance Billing
When a Medicare Replacement is not listed in the payor table what Global code should you use
What is MEDOA
Mask
What is the format of a patients ID number
How do you add an employer to an account
What is info account, Employer and click on add
Name 3 financial classes handled by enrollment
What are Medicare, BCBS, and Medicaid
Three regulatory HMO states that we cannot balance bill in?
What is Florida, Maryland and Rhode Island
AETL1, GWHC, and HUMSR are examples of
What is Defined
Out of State Blue Cross Blue Shield
What is OS***
What steps do you take to update patients mailing address
What is Account Info, Main, F1
Where do you got to check for Enrollment or Reimbursement Issues
What is the intranet
Four examples of payers that we will always participate with regardless of the hospital
What is Tricare, Medicare, Medicaid and Workers Comp
Used for payors we can bill electronically but a defined payor code does not exist and the address has to be keyed in manually each time
What is Global NEIC
Special BCBS payors andwhat do they stand for
What are FEP (Federal Employee Program) and WAL (Wal-Mart)
How do you access archived accounts
What is F4, Info Acct, Arch Info, Yes, Enter, F1, Yes
What financial classes get reported to Reimbursement database for provider related issues
What is VAMC, Managed Care, Non Participating Commercial Payors