MARKETPLACE
When do you have to have a Client sign the Authorization to assist and retain?
Anytime you enter a clients info into Artiva.
What phase does a newborn account go in if they are selfpay and submitting a app?
Application submitted or HPE if that has been submitted
When is it ok to place a grandparents income on a tenncare application?
Only if the child is under their care and has custody. Or if the parent is a minor child.
What can ESS change in medhost?
Anything that you were not born with example: Address, phone number, insurance.
Who is our compliance officer
Matthew Axford
What is the highest Level plan via the marketplace?
Platinum
How do you find accounts that have been referred to you?
Under My Referrals
Where can we find the income and guidelines for Tenncare?
TNHC site and the Eligibility screening services manuals or refer back to the email that was sent via CSS.
What is the 3 day rule for insurance.
The facility has 3 days to update insurance after that ESS can add the insurance to artiva.
Who is our Field Director
Andrew Dye
How would you compare plans via the marketplace?
Marketplace comparsion shopping Tool.
What is PROGID and what do you do with these accounts?
PROGID is screened via the call center and we are following up to process applications and retrieve all docs needed for processing.
What is the maximum amount for the caretaker category.
$2500.00
How do we see a list of all accounts.
F6
What day does Open Enrollment start?
November 1st
What percent is the Bronze Plan
60%
What time do all pools need to be completed by to avoid regional delays?
2 PM CST
What category retro?
Children and Pregnancy and medically needy.
How do we find scanned in items via the facility?
APP bar under Cerner
What day does open enrollment end?
What day does open enrollment end Jan 15th
What is Coinsurance
Coinsurance means you pay part of the bill after your deductible is paid.
If a patient has insurance and has been added via facililty in the first 3 days what do we do with this account?
If its viewable in medhost this would be invalid ess inventory. If its in the first 3 days and not added we would place the account in patient access hold.
What is all needed for an appeal? And when do we appeal?
Proof of all documents turned in and dates. Auth to assist. The reason behind the appeal and where it can be found. When tenncare has an error and not ESS.
What has to match via medhost and artiva to move an insurance to approved?
Name , Address city and state, DOB.
What are 4 examples of docs to scan into hotkey
auth to assist , banking information, release forms, Drivers license , Birth certs, letter of support