Medicare is ran by the government?
True or False
True
Where was the first site created by Sutherland in Jamaica?
UWI
The ability to feel what someone else is feeling?
Empathy
A procedure performed to help with chronic lower back pain.
Chiropractic
We do not follow Medicare guidelines?
True or False
False
What does CMS stand for?
Centers for Medicare and Medicaid Services.
Which site was the last to open?
Portmore
The process of connecting with your provider in a friendly way?
Rapport
What are the 3 P's in healthcare?
Patient, Provider and Payer
What is the difference between diagnosis and diagnostic?
Diagnosis is the sickness or condition, and diagnostic is the procedure.
65+
How many accounts are at the Portmore site?
3
What is meant by AER?
Acknowledge, Empathy and Reassure
What is a copay?
What is the difference between diagnosis and diagnostic?
What benefit when met allows the insurance to cover a member at 100%?
MOOP
Does Medicare have a limit on services performed and what is it based on?
No, based on medical necessity.
How long is the new hire probationary period?
90 days
What skill is important to ensure you get all necessary information from the provider and understand their issue.
Active listening.
What is the difference between fee for service and capitation?
Fee for service is payment per patient and capitation is a monthly payment per a contract.
Services is used to diagnosis or treat psychological disorders, chemical abuse and alcohol abuse.
Mental or behavior health
What is the term used if a member can get both medicare and medicaid?
Dual eligibility
How long has Humana been with Sutherland Jamaica?
3 years
The practice of repeating what the provider stated in your own words.
Paraphrasing.
What is a pre-existing condition?
Patient having a medical condition prior to seeking insurance coverage.
What is timely filing?
How long a provider has to submit a claim for reimbursement.