E-Coverage
Words that help you determine correct plan
What is a keyword?
This is required by insurances depending on the exam and is the reason why appointments are scheduled 7 business days out
What is an authorization?
Item that must match both on insurance card and Epic when verifying Medicare
What is the patient's name?
This self pay coverage is used during the months of May and October for patients needing breast exams
What is Breast Awareness Month?
In Service Now this indicates that a coverage can be verified via e-coverage
What is the letter “E”?
E-cov response that states "unable to respond at current time" means
What is e-coverage is down?
BCBS plan in which keyword on e-cov response only states PPO
What is BCBS PPC?
Medicare patients must have this benefit in order to have outpatient exams covered
What is Medicare Part B?
On a self pay coverage this field is documented with the date of service information
Process when insurance is unable to be verified via e-cov or website
What is email the team leads?
Verify this information when response returns as error unable to process (3 answers)
What is insurance ID, patient's name & DOB?
In general this type plan is referred to as a "Open Access or Choice POS"
What is an HMO plan?
What is a Medicaid share of cost?
For self pay patients this option is used when documenting the pre-cert required field on the Auth/Cert page
What is "9" not required?
What is Availity?
You must do this before reviewing an e-cov response
What is expand the response?
This coverage is created for Indemnity plans
What is Commercial Generic?
This alert indicates patient doesn't have Straight Medicare or Florida Medicaid, however patient has coverage
What is a Medicare or Medicaid replacement alert?
These plans access an insurance network in order to provide benefits for patients
What is a generic plan?
After e-cov response comes back use this option when the patient has the same insurance, but a different ID #?
What is "create coverage" option?
Option when manually adding a coverage when e-cov is down
What is override the query?
Some plans have this identifier on the ID number that helps differentiate between Subscriber & Dependent
What is a suffix?
You must do this on the e-cov response when an alert comes back that the patient has a replacement plan
What is click on "Ignore Response"?
This list of information is needed when creating a new generic coverage for a patient's account
What is type of network plan is accessing, ID #, insurance phone number & claim address?
Option used to verify via e-cov using the specific plan name
What is verify e-cov with a different payor?