Automated Tasks
Medicare Unable to Verify 
Authorization Tasks
Billing – Rev Cycle/Ortho
MISC 
100

This term describes system tasks that are automatically created by RT.  

What are Automated Tasks?

100

The specific location where you can find the Coordination of Benefits form to use when a verification fails due to MSP.

What is the FORM?

100

The teammate you must forward a task to when an attached authorization form requires completion.

Who is the treating clinician?

100

The specific type of task that must be generated when a patient arriving on the 7th reveals they forgot to provide a new insurance card that became effective on the 1st.

What is an Overlap task?

100

The recommended frequency for checking your open tasks in Raintree.

 What is multiple times throughout the day?

200

This is the number of days you should push a Plan of Care (POC) task out when managing it.

What is 7 days?

200

When receiving an “unable to verify” task for Medicare, these next steps should be taken.

What is review the VBEN, update the data accordingly, and/or contact patient if needed?

200

The department where you must “final route” the task once the treating clnician has filled out the authorization form.

What is the A&V department?

200

You should contact this specific team if a patient has a balance-related question that you are unable to answer yourself, and the patient is requesting additional clarification from billing.

What is the Customer Service Team?

200

To ensure proper tracking, the final route of your task should always be assigned to this specific identifier.

What is your clinic code?

300

To resolve a validation (VLDTN) task populated due to a missing case manager, you must complete this specific step before marking the task complete.

What is adding the case manager in the Communication tab?

300

The specific department or action routing step where you must send the task after successfully updating the patient’s Medicare ID number.

What is sending the task back to A&V?

300

Your immediate workflow step upon receiving a task that explicitly states no authorization is required.

What is rerouting the task to A&V?

300

To initiate a refund prior to discharge for a frustrated patient with a large credit who has met their Max Out-of-Pocket amount, you must use this task type.

What is Refund Patient Request?

300

 Because authorization tasks are the highest priority, you should sort your task list by this specific filter to push them to the very top.

What is Type?

400

When a patient "no-shows" their IE and does not reschedule, you must record this specific information in the comments before completing the (SCHED) task.

What is whether you contacted the patient, left a voicemail, or rescheduled them, then marking the task complete?

400

You received a task that says: “Medicare unable to verify. Please confirm patient demographics & Subscriber ID number.” These are the next steps you should take.

What is make sure the name and DOB match exactly what is on the insurance card?

400

When a P2P is required for additional authorization, this is the three-step process that should occur next.

What is informing the treating clinician, calling to schedule the P2P, and notifying the A&V team of the outcome?

400

If a Worker’s Compensation patient’s insurance was not linked to their current case, the IE note was signed, and the balance went to the patient, you must generate this task type.

What is an Account Review / Insurance task?

400

The exact three-step navigation path required to access your tasks immediately after logging in to Raintree.

What is Main Menu > Dashboard > Open Tasks?

500

If a carbon copy task (CC) triggers due to an incorrect fax number, you should first confirm this information, and if something needs correcting, seek assistance from one of these teammates.

What is confirming the fax number with the MD's office? IF the number needs correcting, who are FOBP/FOSS/ Superusers?

500

When documenting a call regarding a Coordination of Benefits issue, you must gather these four distinct tracking details.

What are the date of call, call reference number, name of representative, and turnaround time?

500

This is the standard waiting period – expressed in either hours or business days – before escalating a task that has received no status update response.

What is 48 hours (or 2 business days)?

500

If a patient has been approved for financial hardship and has already accumulated an outstanding balance on their account, you must generate this task type and subtype.

What is Rev Cycle Ortho task type with the subtype Financial Hardship – Account Adjustment Needed?

500

When a patient has an outstanding balance and you are unsure what to do, you must follow this three-step order.

What is reviewing the ledger view and EOBs to determine the cause of the balance, asking the FOBP or FOSS for assistance if needed, and then initiating an account review task if needed?