Stands For..
MRN
Medical Records Number
combination plan vs split plan
BCBS GHI and NYSHIP
Jimmy is inpatient and he is being covered under their spouse Jenna’s insurance. Who is the subscriber and who is the guarantor, and why?
Jenna is the subscriber, Jimmy is the guarantor
financial responsible for the medical bills
Guarantor
it states that the patient is inpatient and we should not disturb them
bed icon in the story board
BCBS HMO
Blue Cross Blue Shield / Health maintenance organization
Medical statement from insurances payors informing and explaining payment details, covered charges, write offs, patient responsibilities and/or denial reasons
EOB / Explanation of benefits
Medicaid eligibility and benefits are exactly the same in every U.S. state?
No, states may have different rules and benefits
I am responsible for the COB, who am I?
The subscriber (who can be the patient as well)
Red and yellow, what are they?
Hard and soft stops
Is HIPPA or HIPAA? PHI
Health insurance portability and accountability act / Protected health information
Fixed amount when visiting a provider / amount of money the patient must pay out-of-pocket before their insurance coverage begins to pay for eligible expenses / you pay a percentage of your medical expenses after meeting your ....
Copay / Deductible / Coinsurance
It is Federal health insurance for people 65 or older (Supplemental)
AARP / Medicare Part C
Elapsed status of the insurance
30 days or more that RTE has not been assessed on the insurance in EPIC
Tabs where we send to and we receive from (Docs)
statement / letters and correspondence list
CRM / FO
Customer relationship management / Filing order
..... offer lower monthly premiums and limited access to in-network providers only, requiring referrals for specialists. ..... offer a wider network, including out-of-network coverage, but come with higher premiums and out-of-pocket costs
HMO and PPO
Medicaid is funded by these two levels of government?
federal and state governments
i got involved in a car wreck, my account will be ...
N/F no fault
when we use CRM?
it is to log interactions with patients when we call them or they call us, Every interaction with patients
DBI / RTE
Do not bill insurance / Real Time eligibility
Offer tax free savings accounts so employees can use to pay for eligible medical dental and vision expenses.
It is the purpose of HSA, FSA and HRA
Prefix used to register the hospital part and the Professional part of BCBS GHI
NYCK / Only K with 2 digits in the end (01 or 02)
An UPS driver was delivering parcels, and suddenly he got hit by another driver and he got hurt, which account may be on EPIC?
W/C Workings Compensation
check mark in full green and light green
Authorization granted and authorization not required in appointment desk