INSURANCE TODAY
HARP/PAS CLIENTS
RECEIPTS - POSTING/FALLOUTS
HARP 3.0
EDG
100
This is used in women's surgery, throat cancer, and heart surgery
What is Robotics
100
This Lab is responsible for performing these tests: OncotypeDX Breast Cancer Assay, OncotypeDX Colon Cancer Assay, Ductal Carcinoma in Situ, MMR, OncotypeDX Prostate Assay
What is Genomic Health
100
This is the Adjustment Code used for most commercial insurances that do not have a default code assigned to them
What is CE
100
This Menu will change according to the page that you are currently on. The Menu options will reflect what you can do from that specific page
What is Related Tasks Bar Menu
100
What are Partnership, Transparency, Convergence?
What is EDG Principles
200
This is California's preferred method of delivering healthcare?
What is Delegated Medical Groups (DMG)
200
EX is the Client Code for this PAS Client
What is Exagen Diagnostics
200
In the Receipts Screen, if this box is not checked, the Adjustment Amount will automatically calculate if allowed amounts are entered for each charge
What is Auto Calculations Off checkbox
200
This is where a user can customize what they see on the search results page
What is Display List Fields
200
Repository of the most up to date, collective edit information gathered from implementation guides, payers, and other third party sources; including clients. Also referred to as the "Wikipedia" of HARP
What is Knowledge Base
300
Medicare, Railroad Medicare, United Mine Workers, Tricare, ChampVA, Medicaid, Worker's Compensation are all part of this type of Insurance Plan?
What are Government Plans
300
This PAS client performs the Foundation One test?
What is Foundation Medicine (FM)
300
This feature in HARP duplicates check information when posting for multiple tickets paid with the same check
What is Bulk Check
300
HARP Documentation can be accessed here
What is The Question Mark Symbol (Harp Manual)
300
What are Habit, Memory, Adjudication Alone, and Common Sense considered?
What is Insufficient Documentation
400
These are the characteristics of what type of Insurance Plan: Employer pays the providers directly (via TPA), No monthly premium to insurance company, no negotiations with insurance company, TPA, NETWORK.
What is Self Funded
400
This lab's tests guide treatment decisions for gastroenterologists
What is Prometheus (PL)
400
These tickets are created when payment is part of a batch, but there are no identifying indicators for posting
What is Unidentified
400
Transacations populate here before they are balanced
What is Unposted Batches Box
400
Edits that are updated every week and reference a code table to determine the validity of a claim
What is Table Driven Edits
500
This person is responsible for the provider charges, generally (but not always) the policy holder
What is Guarantor
500
This PAS lab compares the patient's tumor to 15 different cancer morphologies to determine similarities
What is Pathwork Diagnostics (DG)
500
Over posting, Over adjusting, Duplicate Payment, and Posting Errors all create these type of worklists
What are Credit Worklists
500
This feature allows the user to customize which fields are displayed in the selected search type
What is Parameters
500
These edits are updated on an every other week basis and coded in Quadax's proprietary QuickScript logic as well as DLL logic
What is Hard-Coded Edits