IPLANS
Progressive Auto Insurance
Z-Iplan
The patient is an employee at Lakewood Ranch. They have a coinsurance balance of $500.
Employee Discount of 50% will be applied to coinsurance balance of $500.
Patient balance will be $250.
Attorney called in requesting you email them the balance on the account, Do you email the attorney the balance?
ITEMIZED BILL REQUEST FROM ATTORNEY'S:
Vendor Management's Email Address:
ATLANTICREGIONCBOAgencyMgmt@uhsinc.com
Vendor Management's Fax Number:
(804) 665-2940
Patient DOS was 12/15/25. The patient is calling you today asking if they can send in a settlement offer. The account is not in collections. The balance is the patient's copay. Do you advise the patient to send in a settlement?
No, because the balance is copay and the DOS is not over 2 years old.
Charity Denial Letter was notated on the account but not received by the patient and not scanned to DI. The patient is requesting a copy.
Vendor Management
Uninsured Iplan
910
This $2000 was all deductible. The patient is requesting a discount.
No discount on deductible.
The patient's primary DX code on the account is R.12, the same code is on the physicians' order, the patient is asking you to change it to R.13, what are your next steps?
We will not commit insurance fraud by changing any codes. We will need an amended physician's order if they insist that the DX code is incorrect.
The patient has a balance of $50,000. The DOS was 1/5/2024. The account is in collections. The patient is uninsured. The patient wants to send in a settlement offer. Would you inform the patient to send?
Yes, because the DOS is over 2 years old.
The patient has called 5 times for their refund that is due back to their credit card. Five other reps informed the patient that it's still pending to allow time. Who would you send this escalation to?
Send to PAQ or TL to reach out to Refunds.
What is T90?
Medicare Supplement
The patient had a $200 coinsurance, a $500 deductible and a $100 copay. The patient is looking for a discount. What is the patient balance after the discount applied?
We would offer 30% off the $200 coinsurance. Which would be a $60 discount. The patient balance would be $740 ($140 coinsurance, $100 copay, and $500 deductible)
The patient did not provide us insurance information. It is now past timely filing and the patient is calling to provide you with their insurance. What are your next steps?
Review the account. Make sure we didn't have the insurance information. Advise the patient that we are not able to bill due to timely filing. We can only bill if the insurance were to call and advise us that we can bill them and they will waive the timely filing.
The patient has a coinsurance of $250. The patient wants to settle the account for $25 today. The DOS was 2/1/26. The patient is not in collections. Would you consider the patient's settlement and advise to send in a settlement offer?
No. You would offer 30% off coinsurance and that's it.
Insurance has a balance of $500. Insurance also processed and applied a PTR of $50. $50 is under the patient's bucket.
Variance for possible underpayment review
These are your Medicaid Managed Care Plans
What are the E-Iplans
The balance is SADS we can offer 75% off $250. The patient balance is now $62.50
The patient is also an employee of the hospital, as there is a 920 iplan on the account; the patient has a $50 coinsurance balance. The patient called to receive a discount. Can you offer a discount and how much of a discount can be offered? How much is the balance after the discount is applied?
Employee Discount is 50% off the coinsurance ONLY
Balance owed after the discount is now $25
The patient has a deductible of $1000. The patient DOS was 2/19/26. The patient wants to settle the account today for $900. Would you inform the patient to send in a settlement offer?
No. This is the deductible plus the account is not over 2 years old.
POA called in to report that the patient is deceased.
Complete Estates Request to refer account to DCM
What is F35 used for?
Use this as a placeholder for the Medicare ID number. If a patient has a Medicare Advantage plan, we will add that Advantage Plan on the account as well as add the Medicare ID under I-plan F35, we are not billing F35, it should not be considered secondary, tertiary, etc., it's only a placeholder to represent that the patient has Medicare therefore having a Medicare Advantage Plan is warranted.
Texas hospitals offer a 90% uninsured discount.
The uninsured discount would take $17586 off the total charges.
The patient balance will be $1954
The patient's grandmother called in. The grandmother is listed as guarantor. The patient's mother signed the consents form for this date of service and provided their ID and insurance card. The grandmother is insisting that you update the mother to guarantor. What are your next steps?
Since the mother has signed the consents, the mother has to be changed to guarantor. You have the mother's ID on file, so you will be able to update the mother to guarantor.
We have a Medicare patient with a DOS 2/1/26. The balance is a $500 copay. The Medicare patient wants to settle for $100. Would you advise the patient to send in a settlement offer?
No. It the copay, the DOS is not over 2 years old. We would offer a payment plan as low as $10 a month.
Claim was denied due to medical necessity.