Refresher

KB

100

What KB should you be referencing at all times? 

Per the LOB for your call

200

Which KB should you be using if you have questions on what you can and cannot disclose to someone calling in other than the patient? 

Regulations & Compliance

https://xifin.helpdocsonline.com/regulations-compliance

- Please share your screen and show us where you found this information. 

300

Where do you go to set up a payment plan? 

Depending on your call, you would search payment plan and follow the steps as advised. 

400

Which Kb do we use if we need to gather the note templates? 

Call Templates

https://xifin.helpdocsonline.com/calltemplates

500

Where on the KB can you find the Escalations Teams Distro? 

Per LOB KB path AP , PCCL , Core , PCCL core 

Please share your screen and show us where you found it.

Overrides

100

When submitting an override, which payor do we use? 

We will point the override to the payor where the balance is due. Please keep in mind that if this is not done correctly, this can cause a critical fail and the override notification will not get sent properly to the corresponding team. 

200

Which canned note do we use for override? 

Depending on the override, it should match your canned note. 

300

In what case would we override to Cash? 

CBAL transfers  - Expectation we would add a CBAL transfer override instead 

Missing payments (When the whole template missing payment template is filled out and you search for a missing payment)    

Posting EOB that are ONLY noted in notes and NOT posted on the account.  

400

In what case would we override to FE? 

Unable to find the ins payor 

Need help submitting a claim

500

In what case would we override to RS? 

Posting EOB that are on file  under EOB Tab

Req needs to be requested   

ALL Faxes that need to be located - 48 hours after the patient sent these can be escalated

Any mailed documents needed to be located

Patient being billed for codes allowed at $0   

Random

100

What should we be HIPAA verifying on all calls? 

Obtain FULL Name & DOB

Always confirm if you are speaking with the patient; if not, please gather the name and relationship to the patient and add to your notes. 

200

Do we have to note if we verified secondary insurance? 

Yes- At all times, unless noted by the previous agent who has recently asked, we are not required to verify secondary insurance. ( Please make sure you are reviewing notes on every call) 

300

When would we refer the patient to the insurance? 

Refer to insurance:

Patient disputing the deductible, coinsurance amount or copay due to not feeling like they should have to pay - Note this is only for if they do not have a reason for not wanting to pay. 

400

Do we take collection payments? 

Yes! Please follow the directions per KB for the LOB of your call.

If the patient STILL wants to pay with you - We can reverse from collections and take payment IN the RPM We do have to advise the account will take 30 days to close with collections when we process the payment.  

500

What are the Key points when documenting Accessions/Accounts in RPM?

1. Customers audit our notes—accuracy and professionalism are essential.
2. Use clear, correct language; avoid slang or unprofessional wording.
3. Notes must include important transaction details for the next agent. Do NOT include:
   • System issues (e.g., “slow internet”)
   • Patient emotions or irrelevant comments
     • We want to maintain professionalism in our documentation.
     • We want to remain factual and avoid excessive emotions that are not related to the call or that will not assist with the situation. For example, if someone is yelling, cursing, etc. instead of writing, "Patient called screaming saying B$$$$ ect" we would say, "Patient called extremely escalated." We want to write our notes as if we owned XIFIN and what would XIFIN/Clients/Customers need to know about the patient call.
4. Ask yourself:
   • Will this note help the next person?
   • Did I clearly define steps taken and next steps required?

Email Escalations

100

What are some scenarios we would email path TMs for? 

Sup calls 

PHI and PCI Reports ( pause the recording when taking a payment and recorded the CC number )

200

Do we send an escalation email if it's the first time the patient is calling in? 

NO - We should be able to determine the root cause of the call and assist. If we happen to need to escalte that would be more of an override for first-time callers. 

300

What is the email format that should be used for the Subject line and body for all escalated emails? 

Subject line: IDX Invoice number Reason for escalation 

Body: Please see notes

Please note 

• Our subject Reason for escalation should only be no more than 2-3 words about why we need the account reviewed

400

How many times does the patient need to call in for the same issue for us to send an escalation email? 

• If the patient has called more than twice regarding the same issue, please note that it is required to note in the email how many times the patient has called.

500

Who needs to be added to all email escalations? 

CC "Path Agents" > and "Brittany Dalton" > and "Alexa Arroyo" > to all emails  

Random

100

Do we send out text messages to Patients? 

NO - If a patient is NOT in RPM in any of our environments and they are in IDX - we can provide the email: [e-mail] for the patient to contact, as well as the 877-456-6706 number. The email address is worked within 24 hours. We can advise them of this so hopefully they will email - Please ONLY provide the email for this situation.  

This is located at the top under Updates per the KB lob your on. 

200

Does Path report to the credit bureau? 

NO - Path does not report to the credit bureau 

300

Do we refer patients to contact MDO?

WE NEVER REFER TO THE MDO UNLESS THE KB SECTION SPECIFICALLY SAYS TO 

400

Which dunning cycle would be used to issue a statement to the patient? 

Dunning 1, 4 & 5 are text messages.  

Dunning 3 is an outbound call  

Dunning 2 is statements  

500

Where do we check if the insurance is not being billed properly to confirm the reason? 

Eligibility History