Check 1st
Name, DOB, address
This is the term for the process of contacting insurance companies to resolve unpaid or denied facility claims
Follow Up
This type of payment is made by the patient before services are rendered, often based on an estimate.
copay, prepayment, etc
UHIS
RC9u or Invision
This federal program provides health insurance for individuals 65 and older or with certain disabilities.
Medicare
When running eligibility to confirm coverage type
Name of Ins, Product type, Elig dates
This type of denial occurs when the insurance company says the service was not medically necessary
medical necessity denial
This is the term for the amount a hospital expects to collect from all payers for services rendered.
Expected payment/reimbursment
EOB
This British band famously crossed Abbey Road on one of their album covers.
The Beatles
When initiating follow up on an encounter
Acct type, Ins code, rep # present?, balances, notes
This is the formal process of challenging a denied claim with supporting documentation
Appeal or reconsideration
This is the contractual agreement between a hospital and an insurance company that determines how much the hospital will be paid for services.
Contracted rate
Patient responsibility
copay, coins, deduct, non covered service, etc
This dense, creamy dessert is famously associated with New York and often topped with strawberries or cherries.
Cheesecake
Before billing a patient
pt resp has been assigned, clm correctly processed by all payers
This code set is used to describe diagnoses on medical claims.
ICD-10
Which payer always pays the least?
Medicaid
PFS
Patient financial services, revenue cycle, Business office, etc
Who in follow up has the most kids?
Shobana
Before asking a question of your coworkers or supervisiors
Check One NOTE, emails, or reference material, and intranet
This term refers to the portion of the bill the patient must pay before insurance begins to pay.
Deductible
This is the process of applying payments received from insurance companies and patients to the appropriate accounts and services in the billing system.
Cash Posting
CPT
Procedure code, Billing code, Service code, & HCPCS
What does HIPPA stand for?
Health Insurance Portability and Accountability Act