A
Full name and Date of Birth are 2 non-negotiable verifiers in verifying the patient's account. True or False?
True
The caller is the husband of the patient, he is calling to pre-register his wife for L&D. His name is not listed an authorized person but added as an emergency contact. You can still proceed with pre-registration and disclose PHI to husband. True or False?
False
What type of code do we need to add/input for Labor & Delivery for the patient's LMP?
UB CODE
What's the proper threshold in placing the patient/ caller on hold?
1-2 MINUTES
What is the type of doctor that assists patients with routine check-ups and examinations?
Primary Care Physician
What activity code do you need to put if the patient wants to cancel his/her appointment?
6319 - General Note
Yes or No. The insurance note says DO NOT COLLECT. Do you still need to discuss the estimated liability to patient?
YES
"We were able to verify your insurance, and we have benefits to review with you.” (Provide all the benefits breakdown) Benefits are based on your insurance as of today for services ordered by your physician. Some physicians or professional fees, supplies, medications and devices may not be included and would be billed separately.”
PAC Benefit Details
These 5-digit codes describe services performed by physicians and medical professionals, such as diagnostic tests, surgeries, or office visits.
Procedure/ CPT Code
The patient needs to update their name on the record and she just got married; patient is fully verified. Are you able to update it over the phone?
NO - this can only be done in the facility as they need to precent any necessary documents
Pre-Registration Completed with Estimate Applicable but patient said "I would like to speak with insurance first before I make a payment.", what will be the PAC note summary?
$X.XX_Pt Contact
6523 is for PAC DO NOT REGISTER. True or False?
FALSE - 6523 is for DO NOT CALL
MSPQ is applicable to patients who have Medicaid as their insurance. True or False?
FALSE
The person who is held financially responsible for medical expenses incurred on a patient’s behalf.
Guarantor
What will be the PAC code if pre-registration has been completed and you were able to collect payment via Experian?
6336 + 6318
"Your estimated financial liability is zero ($0.00). This is not a guarantee of final billed charges. Estimates are based on your insurance benefits as of today for services ordered by your physician. Some professional or physician fees, supplies, medications and devices may not be included and would be billed separately.” What type of disclaimer is this?
Zero Liability
What additional notes do you need to add if patient completed pre-registration but there is no insurance note on file yet?
Demographics verified - No IV notes yet
For Medi-Cal, Cosmetic, GID, Transplant and Charity Care Patient. There shouldn't be no DISCLAIMER, do not provide any estimate.
Is this statement true?
TRUE
What are the 5 sub-processes we are supporting in Sutter Pre-registration?
INFUSION, HSD, L&D, SURGERIES & RAD
What note type should you use for non pre-registration concern?
General Note
Patient estimate applicable?: Unknown
Discussed estimate with patient?: No
Disclaimer read?: Yes
The information above can be seen in what Insurance Notes?
PAC Benefit Detail
A _______ is the estimated out-of-pocket balance the patient will have for their services/ appointments.
RESIDUAL
A workers' compensation _____ ______ is a unique, alphanumeric, or numerical code assigned by an insurance carrier or state agency to an employee's work-related injury report.
CLAIM NUMBER
We are allowed to provide the date and time for ALL types of services to the patient/ caller.
FALSE
How does a patient qualify for Medicare?
65+ years old
Under 65 but with disability
Diagnosed with ESRD