Insurance
NAME ONE ADDITIONAL INFORMATION NEEDED FOR A WORK COMP ACCOUNT?
CASE MANAGER AND/OR ADJUSTOR, TPA IF VALID, DOI, CLAIM#
WHERE CAN YOU FIND A FORM LINK SUBMISSION
On your SOC team page under the front office coordinator library, under “FORM LINKS".
WHERE CAN YOU SEE THE HISTORY OF TEXT MESSAGES SENT FROM RAINTREE?
WHAT DOES XXGEN AND XXFED STAND FOR ON THE SCHEDULE?
XXGEN stands for the general hour. You may schedule workers comp, self pay, general, map, and dry needling/wellness plan follow ups/evals on this.
XXFED stands for our federal hour. You may schedule Medicaid and Medicare follow ups/evals on this.
WHAT HAPPENS IF YOU DO NOT COMPLETE THE MONTHLY FOCUS 15
Pay will be suspended and you will be unable to login into raintree
NAME TWO EXAMPLES WHEN YOU WOULD USE FEDNP AS A SECONDARY PAYER
1) MAP DUAL COMPLETE -- FEDERAL
2) COMMERCIAL -- FEDERAL
3) FEDERAL -- FEDERAL
4) ANYTIME FEDERAL IS SECONDARY, UNLESS TRADITIONAL MEDICARE IS PRIMARY THEN WE BILL AS TENNESSEE MEDICAID
WHO IS RESPONSIBLE FOR UPDATING THE MAPPING SYSTEM?
THE CLINCIAN IS RESPONSIBLE FOR MAINTAINING THEIR INFORMATION
HOW DO YOU DEACTIVATE A PATIENT WALLET?
PATIENT FILES -> ACCESS PATIENT WALLET -> CLICK ON THE CARD -> UNCHECK ACTIVE OPTION
WHAT IS SEM AND WHAT DOES IT MEAN?
SEM stands for Schedule Efficiency Model. It means to provide efficient, compliant, and high-quality care while increasing access to the communities we serve. It gives our clinicians the ability to have a well planned out day to ensure they do not feel overworked and gives our oc’s the power to manage the schedule according to our designated templates.
HOW MANY DAYS DO YOU HAVE BEFORE A POC IS CONSIDERED NON COMPLIANT?
30 DAYS
WHERE DO YOU INSERT A PATIENTS INSURANCE CARD AND ID?
INSURANCE TAB FOR INSURANCE CARDS AND ID UNDER PATIENT DEMOGRAPHICS
WHERE IS THE START PROGRAM ON THE SOURCE?
Professional Development Page
WHAT CATEGORY DO WE CHOOSE FOR PHI FORM?
You will use the category “Miscellaneous” and rename it “PHI”.
WHAT IS THE DIFFERENCE BETWEEN A TRADITIONAL MEDICARE VS A MAP PLAN
Traditional Medicare is the normal red white and blue card. A MAP plan is Medicare combined with another insurance in the card.
WHAT STEPS SHOULD YOU TAKE WHEN YOU SCAN INCORRECT PATIENT INFORMATION INTO ANOTHER CHART?
IT Ticket – I’m facing an issue – HIPPA privacy – Select Scanning Errors/ Duplicate Accounts
WHAT INFORMATION IS NEEDED WHEN EDUCATING BENEFITS TO PATIENTS?
CO INSURANCE OR COPAY, DED AMOUNT, DED MET, PATIENT RESPONSIBILITY
WHERE CAN YOU FIND THE WEEKLY OC AGENDA?
SOC Page, under Wikis
CHARGES HOLDING AND FUTURE AUTHORIZATIONS
WHAT ARE THE STEPS AND CODES TO BLOCK A CLINICIAN SCHEDULE IN RAINTREE?
Right click and highlight the area needed to reserve time on the clinicians schedule and use the OUT, MTG, or ADMIN codes. You can also leave a comment down in the box to give a description as to what the blocked out time is being utilized for.
WHO IS RESPONSIBLE FOR SCHEDULING INTERPRETERS AND WHERE DO YOU FIND ADDITIONAL INFORMATION
THE CLINIC IS RESPONSIBLE FOR SCHEDULING THIS AND ADDITIONAL INFORMATION UNDER QUALITY ASSURANCE
NAME 5 INSURANCE PLANS CONSIDERED TO BE FEDERAL PAYERS
TRADITIONAL MEDICARE, TRICARE, UHC COMMUNITY PLAN, BLUECARE, AMERIGROUP
WHERE DO YOU FIND PINNED PAGES?
CLICK ON YOUR NAME, THEN GO TO PINNED
WHEN A FAXED REFERRAL IS RECEIVED IN___ ____, WE SHOULD MOVE IT TO ____?
DOC ROUTING AND THEN JOURNEY
WHICH APPOINTMENTS CAN BE SCHEDULED IN ANY HOUR SLOT WITHOUT IMPACTING BILLING?
Skilled Training, Dry Needling, Work Conditioning, FCE
WHAT INFORMATION IS NEEDED WHEN AN AUDITOR COMES TO YOUR CLINIC AND WHAT DO YOU DO?
ASK FOR IDENTIFICATION THEN REPOR IT TO CLINCAL SERVICES FOR TRACKING