CASING
Which group assist with casing an account?
Compass Support
Who can uncase an account?
Who is me, you, and you. Any AR, PSR, TL, etc. can uncase an account.
Which account types or scenarios are usually linked?
What is Mom & baby or Parent and Minor child that are on the same application, all family members in the same household and on the same app.
Who is responsible for closing Accounts?
Who is all of us.
*If we discover an approval, denial or other close reason such as pt. is uncooperative and account timed out, it is our responsible to close the account.
Do we have to unlink an account in order to approve or deny an account?
**This is different then cased**
What is the purpose of casing accounts?
What is:
- Saves Time
- Easier to work the accounts
- Ensures all accounts are being worked properly
You are working an account and you get approval for one of the cased accounts. What are the steps you take?
- Uncase the approved account. Upload approval. Notate. Approve it. Continue to work the account for all other dates of service.
Can you link 2 adults accounts that are in the same household and on the same application?
What is Yes. The accounts for all family members are always linked, as the apps are worked together. 1 app for all family members.
Under which tab do we close an application?
What is the Applications tab - > application Denial.
With EMA Labor and Delivery cases do we need to request an EMA statement thru spreadsheet or complete a 2039 form?
What is complete a 2039 Form.
Mom & Baby
ABD
EMA
Which of the account types would you typically case if there are more than 1 account?
What is Disability.
When do we uncase accounts?
What is when approved or closing.
Under which tab can you find linked accounts?
What is under the Guarantor Referrals tab.
What is the next step after closing an account?
What is complete the task for closing
* Always check to see if there are secondary payor programs, like HCRA or Charity care.
What document is needed in order to submit a 2039 form to DCF?
What is Medical bills.
When casing an account, which account would you make primary?
What is the oldest account that is still eligible for Retro.
What happens when you approve or close an account without uncasing the accounts.
What is All accounts and dates of service will be approved or closed.
Who / What is Compass Support.
which other scenarios may require an account to be closed?
What is unlocatable and Uncooperative / Timed out.
Which Payor program are still eligible for 90 day retro?
What is: Pregnancy and ACA children.
Jill who is an undocumented alien came to the hospital on 01/01/2019 suffering from a headache. She was assessed, treated and discharged. Jill then presented to the hospital again on 01/15/2019 with facial paralysis and slurred speech, she was assessed and dx. w/ a stroke. The payor program was determined to be Emergency ABD. Would we case this account?
What is NO.
***All EMAs must be worked separately because they do not qualify for continuous coverage. So each case is handled on a case by case basis.***
Can you change your primary account w/o uncasing the account? If so how?
Jill is in labor and goes to Winnie Palmer and delivers a bouncing baby boy named Jackson. Jill's boyfriend Jack was seen at ORMC around the same time for a spine injury. Jack does not live in the home. Which accounts are we linking?
What is Jill and baby Jackson.
Before deciding to close an account what should we make sure of or review prior to closing?
What is:
Reason for close is valid
- Denial reason is valid
- Approved for all dates of service
- Can app be Re-used
- Can we submit a new app
- Have we exhausted all available resources to move this account towards an approval.
When do you re-submit an application when patient is enrolled in Medically needy?
What is: NEVERRRRRRRRRRRRRR