INSURANCE POSTING
Name Three Medicare payors
Anthem Medicare, United Healthcare Medicare, Medicare of Va. (other Medicare payors acceptable)
72 PLB Definition
WHAT IS A RETURN OF A REFUND
This acronym stands for the document sent by the payer explaining how a claim was processed.
What is an EOB (Explanation of Benefits)?
TPL
WHAT IS Third Party Liability
This tool allows you to match bank deposits to electronic remittance files in Epic.
What is the Cash Management Module?
HB and PB clearing houses are
WHAT IS WAYSTAR, AVAILITY
HUMANA PLBS BELONG...
WHAT IS HAR/INV LEVEL
This term refers to the portion of the fee that a participating provider must write off, which is the difference between the billed amount and the allowed amount.
What is a Contractual Adjustment/Allowance?
CPT
WHAT IS Current Procedural Terminology
This type of automated file, abbreviated ERA, is matched with bank deposits in Epic.
What is an Electronic Remittance Advice?
NAME OUR CURRENT HOSPITALS
PRINCE WILLIAM, HAYMARKET, CULPEPER, UVA MC
What program is used to edit 835 files
WHAT IS NOTE++
This type of code on an EOB indicates the reason for a claim adjustment, such as a denial or a reduction in payment.
What is a CO45 CARC
EFT
WHAT IS Electronic Funds Transfer
This process, formerly manual, is now automated by linking deposits to bank records.
What is reconciliation?
This is the first step in the revenue cycle before any cash can be managed
What is Patient Registration?
Undistributed payments are stored where for HB and PB
What are Undistributed Workqueues
This payment type refers to funds deposited directly into the provider's bank account, often accompanied by an Electronic Remittance Advice.
What is EFT (Electronic Funds Transfer)?
HIPAA
WHAT IS Health Insurance Portability and Accountability Act
THESE TYPES OF CASH STATUSES STILL HAVE A BALANCE TO POST
WHAT ARE PARTIALLY POSTED, CONFIRMED AND CREATED
When researching the HAR/INV what do you click to see the ERA
What is Remittance image hyperlink
Automatic action of payments posting
What is AutoPost
These are the two types of codes that must be matched when posting, which are required for correct charge capture and payment application.
What are CPT/HCPCS and ICD-10 Codes
NPI
WHAT IS National Provider Identifier
These amounts need a journal entry or more research
What are external amounts