Business Office Assessment Flashcards
Private Payor accounts can be collected in advance with the exception of which private payer (s)?
Medicare CoInsurance from Private
Which Payor Type can we collect coinsurance in advance?
HMO/Medicare Adv Health plans
When should the resident be notified of their co-pay amount due?
upon admission (within 48hrs and weekly billing with follow up
Per our collections policy the_____th day of the month is considered past due on a continuing monthly private payer account?
10th
The 1st collection letter should go out to current in-house residents by the ______ of the month?
20th
All collection activity; phone calls, collection letters, any correspondence from the resident or responsible party should be clearly documented where?
PCC Collection Module - Resident
Best practices if the BOM has sent out the statement with the due date for payment and collection calls collection letters have been sent out the _________ would get involved?
ED
When should Medicare coinsurance from insurance be moved to Medicare coinsurance from private if not originally booked as such?
Upon receipt for of the insurance EOB be notifying the facility that they will not pay coinsurance
What email address do you use in order to request an asset search?
Assetsearch@ensignservices.net
A resident who exhaust all 100 days in a skilled nursing facility but is still receiving skilled care services must submit what type of claim to Medicare monthly?
Benefit exhaust clamp
A resident becomes eligible for Medicare part A benefits on 12/1/16 and was in the hospital as inpatient from 11/ 25/16 to 11/30/16 can be covered under Medicare part A for their admission on 12/3/16? Yes or no?
No resident must have a three day stay once they are eligible for part a benefits
Occurrence span code WHAT is used when part of a residence day is considered provide reliable?
77
Occurrence code WHAT is used on the UB04 to identify when a resident skilled level of care is ended along with the date active care ended
22
Medicare part a no pay claims are billed with WHAT type of bill and condition called WHAT
210, 21
Value code 80 is
Value code 81 is
Value code 82 is
Value code 09 is
- Total number covered days
- Total number non-covered days
- Total number coinsurance days
- Medicare coinsurance amount