The person that is ultimately responsible for paying the patient's bill
Who is the guarantor?
Validating with payors that a given plan is active.
What is eligibility verification?
D in AIDET
What is Duration?
Most important person in healthcare.
Who is the patient?
The application used to find the resolution rate.
What is employee scorecard?
Insurance company MHS does not have a contract with.
What is out of network?
When an insurance company refuses to pay a claim, we have submitted to them.
What is a denial?
I in AIDET
What is Introduction?
One of the 5 pillars of the Standards of Excellence
What is Treat everyone with courtesy and respect
Show care and compassion in everything you do
Connect every person to build a trusting relationship
Seek to understand needs and strive to exceed expectations
Keep the patient at the center of everything we do
Calculation of a patient's out of pocket expense.
What is an estimate?
Dashboard that is used to see what patients are in the ED and ready for registration
What is EDM tracker?
The process of identifying which insurance should be billed first for patients with multiple insurances.
What is coordination of benefits?
E in AIDET
What is Explanation?
The individual who carries the insurance coverage.
Who is the subscriber?
Form the patient must sign if they are SP/elect. Except in the ED.
What is waiver?
Emergency Medical Treatment and Active Labor Act
What is EMTALA?
Where you go to find out if MHS is in or out of network with a particular insurance or which mnemonic to use.
What is insurance mnemonic manual?
A in AIDET
What is ACKNOWLEDGE?
Process to obtain approval for a specific service to be provided to the patient.
What is pre-certification?
Agreement between the patient and the health insurance to pay a fixed fee for medical services.
What is a co-pay?
Name 2 ways to verify a patient identity
What is name, date of birth, ssn,.
If unable to verify insurance eligibility through AccuReg or Phreesia, do this?
What is call payor or check website?
T in AIDET
What is Thank you?
The CFO of Memorial Health System.
Who is Scott Silvestri?
What are the 5 different communication tools for patients to receive notifications?
What is mail, phone, text messages, emails, and mymemorial chart.