Insurance
For commercial insurances what are the 2 things that need to be scanned in every year?
Both the insurance card and online swipe.
If a patient approaches you without you calling them over but you are available to take them, should you take them?
Yes. You can politely let them know that next time they need to wait to be called but if you are available you should not turn them away.
When creating an new appointment, how do you determine what the department is?
By the resource.
If a patient gets paid every week how many pay stubs do we require?
Most recent 4 pay stubs.
Where should the foster parents information be placed?
In the hub notes.
How should every insurance card be scanned in?
Front and back and in color
A patient signs the papers wrong 3 times. What is a way you can ensure they sign it right?
How do you know who the Guarantor should be?
Whoever signs the General consent form.
Who signs the SFA form?
The patient themselves or the parent of the patient.
What number should always be responsible party?
99-Ward of State
If an insurance is inactive what are steps in ECW that we should do- Hint, there are at least 3.
Terminate the insurance, download the inactive swipe and change the VFC status.
No. You should carry on as if you did not notice them on the schedule.
Can a minor be listed as guarantor?
No- only parent, legal guardian or Ward of State.
When calculating income from the pay stubs, do we use include overtime, holiday, bonus etc?
No. Only gross pay.
DOUBLE JEOPARDY: A mom comes in a says that her child is no longer in foster care and has been placed back with her but she does not have documentation. What are the next steps the SRS should take.
Call the case manger to obtain verbal confirmation. If the case manager does not answer a substituted should be used and the provider MUST AGREE to see the patient and sign Substituted BEFORE the patient can be seen.
How can you be certain that traditional Medicare has a commercial replacement?
Open the "Contact other entity tab and find the "bill option code -C" message.
If a patient yells at you and calls you names is it appropriate to ask them to refrain from name calling?
If a patient does not have active insurance, what should the SRS do for the patient?
Offer the SFA (if applicable) and offer an appointment with Enrollment.
When a parent signs the SFA, can they use their name on one line and the other parent for the signature line?
No. The parent must use their name and signature only.
What should the Healow messenger be set to and what box should always be checked?
Declined yyyy/mm/dd/SRS initials. "patient opts out of all practice communication."
If a patient has both active traditional Medicare as well as a replacement Medicare insurance what should we do to the traditional Medicare?
Terminate the traditional Medicare and leave on the preplacement plan as primary.
If you do not speak the same language of your patient, what should you do?
Use Globo or CLI
If no PCP is listed on the insurance swipe who should you use?
Your center co-leader
Pro tip: always choose from the referring list
True or false: the expiration date for the SFA should include the entire date of expiration?
Yes- writing just the year it expires is not acceptable.
Which Global alerts should always be added to that patient chart?
Foster Care and disable Healow messenger and do not web enable.