Front Desk For Billers Ch.2

Question 1

True or false: When creating a coverage record in the system, you must choose the correct Payer and Group number listed on the subscriber insurance card.

Answer 1

False: payer and plan

Question 2

True or false: a patient can have more than one guarantor account.

Answer 2

True: however, only one guarantor account can be linked to a specific visit.

Question 3

Prelude

Answer 3

Enterprise registration holds the basic patient guarantor account and coverage data.

Question 4

Cadence

Answer 4

Scheduling. Schedule and check in visits. Collect visit-specific data.

Question 5

Resolute, professional billing

Answer 5

Billing for professional services. UB and CMS claim forms available.

Question 6

Single Billing Office

Answer 6

Using an integrated set of tools to send statements and follow ups on those self-pay balances. Requires the use of an encounter specific account HAR in both HB (called a hospital account) and a PB (called a visit account).

Question 7

W/C and TPL guarantor account types.
TPL= third-party liability

Answer 7

Accident related?

Question 8

A patient can have multiple guarantor accounts.

Review that the correct guarantor account type is used for the visit.

Visit filing order: which coverage to bill for this visit and it what order .

Answer 8

Visit guarantor and visit coverage

Question 9

Person/entity financially responsible

Answer 9

Guarantor

Question 10

Payor, plan, subscriber

Answer 10

Coverage

Question 11

The system can automatically filter, which coverage should be used on certain types of visits in order to determine the filing order for that visit.

Answer 11

Like dental coverage won’t be added to visits where the department specialty is family medicine

Question 12

What’s created when the encounter is checked in?

Answer 12

Encounter form number

Question 13

What’s created when the encounter is created?

Answer 13

CSN = contact serial number

Question 14

Can a visit auto pay only be set up in the front Desk workflow?

Answer 14

No, it can also be set up by a guarantor via my chart.

Question 15

What happens if the self-pay amount exceeds the consent amount?

Answer 15

There’s a setting that controls this. The guarantor can be charged up to the consent amount, or the visit auto pay can be cancelled without processing a payment.

Question 16

How does the guarantor get notification that the auto payment has been processed?

Answer 16

This will follow the set up for Balance notification for your organization

Question 17

For non-generic coverages, co-pays information and typically received from real time eligibility - RTE.

Answer 17

This data is store for each encounter/visit in the foundation system.

Question 18

For generic coverages

Answer 18

Co-pay, values can be manually entered from the insurance card into the coverage level co-pay fields. This co-pay will be available for use for all subsequent visits using the coverage.

Question 19

Payment code examples: co-pay, pre-payment, guarantor payment.

Payments from the front Dess are posted to the account immediately .

Answer 19

Payment and payment codes

Question 20

Front desk for billers

Answer 20

I reviewed: patient, guarantor account, coverage, encounter form number, Patient estimate