Middle Cycle
Once the episode of care ends, the patient is discharged and this part of the revenue phase begins.
What is the In-Audit Phase?
After the medical record has been coded, the information will be sent to this team.
What is Billing?
Charge Code C1894 has 2 units and the total charge is $1,040, this is the amount per unit.
What is $520?
This financial class is responsible for billing institutions such as nursing homes or hospice that use our facilities for services.
What is Client Bill?
For each insurance that is billed, this is assigned that is responsible for continued follow-up.
What is financial class?
This tells the patient's anticipated location after they leave the hospital.
What is disposition?
These categories are located within a Uniform Bill.
What is Patient's general information , provider information, procedure, diagnosis, charges and insurance information?
This claim is missing important information or is formatted incorrectly and the payor is unable to process the claim for payment.
What is rejected claim?
Insurance companies that place limits on physician fees by controlling costs and restricting the patient's choice of physicians and medical facilities.
What is Managed Care?
This is defined as a positive or negative amount that indicates a potential error in an adjustment, a log sheet, or a manually posted payment.
What is a variance?
This team ensures all the appropriate charges are entered into the patient's account.
What is Charge Capture?
Services provided to a patient at the hospital.
What are charges?
This team is responsible for retrieving facility medical records or documentation for the appeal review on claims that have been denied.
What is the Denials Support Services ROI Team?
This is an adjustment taken by the Follow-up Team.
What is Denial Adjustment?
The three neighborhoods within the Cash Team?
What is prepping, posting and balancing?
What is Patient Access?
RT is an example of this
What is a Modifier?
This team manages claims that the payor has paid and then denied.
What is Post-Pay denials?
What is who, what, where, when and why?
This defines what portion of the encounter was not paid for by the patient's insurance company.
What is a Remittance Advice?
This department is responsible for coding and medical record management.
What is HIM?
A patient's diagnosis and length of stay are determined by this code.
What is DRG?
This team is responsible for reviewing multiple accounts for overlapping dates of service.
What is the Unbilled Team?
If an account is sitting in the wrong financial class, the follow-up specialist takes the appropriate action to move the account to the correct follow-up team so it is properly worked and maintained. (True or False)
What is True?
What is Hyland?