Verification
In pre-call work, you notice a target fax was successfully sent. On the call, we proceed to...
What is confirm the target fax was received?
State one reason why Risk Adjustment is important.
What is financial benefit to health plans, prevents substantial money loss, supports government reimbursements, or additional support for sicker population/patients with chronic conditions?
The facility asks where to upload the records. We reply they can upload it to...
What is submitrecords.com?
The facility states that records will be uploaded by end of day. You advise them to...
What is write down the reference number?
We call the facility and the representative is only able to verify the provider, facility name, address, and fax number. There's no one else available to speak to, no alternate contact information, and there isn't a website available. We proceed to...
What is send the request?
You call the facility, reach the receptionist, and inquire about the medical records request. The receptionist proceeds to asks whether this request is for an audit. You inform them it isn't and that it's part of the _________ process.
What is Risk Adjustment?
When searching the Upload Portal, we shouldn't delete...
What is the asterisk symbol?
The facility explains they are understaffed and a years worth of records is going to take them a long time to process. To make it easier on them, we offer...
What is specific dates of service?
We call the facility and they state they've received multiple requests for this patient. Looking at the notes, we don't see that a request has been sent. We proceed to...
What is search for duplicate sites/determine if there's a centralized location?
What is they don't provide an accurate picture of the patient's overall health?
The facility provides us with the upload information and we're unable to locate the records despite adjusting the dates. It's been more than twenty-four hours since they were uploaded, we proceed to...
What is ask the facility to re-send the records?
It's the start of the project and we call the facility for a verification call. We're able to obtain the necessary information except a commitment date. They say no to sending records by next Wednesday. We should...
What is express urgency and push for another commitment date.
There's a main phone number listed and a contact number. We call the contact number twice and reach a voicemail, we opt not to leave a message. We proceed to...
What is call the main line?
Risk is calculated by...
What is Risk Adjustment Factor (RAF)?
The facility is having a difficult time uploading the records. We get ready to start the troubleshooting process. Name one troubleshooting step we should take with the facility...
What is browser, file type, file size, password, or portal down?
Hierarchal Conditions Category (HCC) model is for...
What is avoid counting similar conditions?
We call the facility and verify the facility information. We ask for a commitment date and they state their infamous line of, "we have thirty days." We push back with...
What is the client has given fourteen days for this request to be completed?
One benefit of Risk Caculation.
What is predict future medical costs, manage patient health, or benchmark provider performance?
We search the upload portal by the reference number and date provided, but no results generate. We remember there's an adjustment we can make to ensure the records weren't received. We...
What is adjust the dates?
What is record tracker?