Show:
Terminology
Revenue Cycle Process
Charge Review
Payment Posting/Self Pay
Claim Edits
100
define RCS
what is revenue cycle solutions
100
Reviews charges for errors before filing to guarantor accounts. This is still in Pre-AR until out of WQ
What is Charge review?
100
This work queue captures errored charges
What is Charge Review
100
electronic remittance Advice
What is ERA?
100
used to evaluate claims for errors (used to devolop rules to catch errors)
What is Claim Definition file/ CDF?
200
Entering procedure/DX codes into EPIC to start the claim process.
What is Charge Entry?
200
The process of making an appt, Entering pt demographics insurance info.
What is Patient Registration & Scheduling?
200
the charge review WQ reviews charges for errors beofre filing to....
What is guarantor account
200
created by deposit services for posting
What are batches
200
a claim requires a specific document or report with it it falls into this WQ
What is attachment WQ
300
define CDF
what is claim definition file
300
Manual Charge Entry for PB charges
What is PB Charge entry
300
Skips charge router, charges go directly to charge review
What is PB Charge entry?
300
these are worked in remittance WQ's
What are remittance errors
300
this team works claim edit WQ's
Who billing team
400
define the acronym FFS
what is Fee for service?
400
once the claim passes inspection, the_____ transmits the electronic claim to the specified payer.
What is clearinghouse?
400
while charges are in charge review the charge is considered Pre-AR (answer with a ? of TRUE or FALSE)
What is TRUE
400
self pay balances fall into these WQ's
What is Account WQ
400
all errors needf to be cleared before claimcan be resubmitted (answer with ? of TRUE or FALSE)
What is TRUE
500
to return money to the insurance company
What is a refund?
500
follow up on outstanding claims;unpaid either through no response or denials.
What is AR Follow-up
500
once charges are entered, they go into this WQ
What is charge review WQ
500
when the charge balance is 0
What is a completed revenue cycle process?
500
this entity ensures a secure transmission of patient PHI to the payer
What is clearinghouse?