Core Values
We Care
Revenue Cycle
Medicare COB
Workflow
100

Serving others: our reason for existing. We continually seek to understand the needs of those who depend on us (our patients, doctors and our fellow team members) and then to exceed their expectations.

Service Excellence

100

W

Welcome

100

Working with medical partners to place patients

ADMISSIONS

100

A Social Security Beneficiary is Medicare eligible upon:

A. Attaining age 65, B. Qualification for disability benefits, prior to attaining age 65, or C. Diagnosed with ESRD or Lou Gehrig’s disease (ALS), regardless of age.

100

These plans are controlled by the employer

Self funded

200

We never stand still; we are never satisfied. Individually and as teams, we constantly look at what we do and ask, “How can we do this better?” Then we use a systematic approach to take action.

Continuous Improvement

200

E

Empathize

200

Setting coverage in our billing system

PATIENT REGISTRATION

200

Calculated using the FDODE, the payment of any Medicare benefits due to an ESRD entitlement may be subject to this 

3 month wait period

200

Often more than 1, attempt to resolve all of these in 1 dispute/appeal

root cause

300

We don’t say “It’s not my fault” or “It’s not my job.” We take responsibility for meeting our commitments - our personal ones as well as those of the entire organization. We take ownership of the results

Accountability

300

C

Connect

300

Generating claims and sending them to payers

CLAIM GENERATION

300

It's against the law for someone to knowingly sell or issue this to someone who already has Medicare coverage

Exchange Plan

300

Included at the end of a protection note to pull entire account protection as opposed to claim by claim

#

400

We enjoy what we do. We know healthcare is hard work, but even hard work can be fun. We take our jobs seriously, but we feel a fun environment delivers better care to our patients while creating a better work environment for our teammates. We strive for excellence and we have fun

Fun

400

R

Respect

400

Working with patients to find the best insurance

IMT

400

Less than 6 months and considered active employment

Short Term disability 

400

Benefits handbook employer provides, document outlines benefits and requirements which often supersedes DVA contract with payer

SPD (summary plan description)

500

We say what we believe and we do what we say. We are trusted because we are trustworthy. In our personal, team and organizational values, we strive for alignment in what we say and do  

Integrity

500

E

Encourage
500

Following up on payments

CLAIM COLLECTIONS

500

Key to determining COB. This is not the same as an active EGHP

Active employment

500

Credit Balance Policy for Non-Gov’t Non-Primary to Medicare and Medicare Advantage COB related

3-08-100