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AR1BOOTCAMP03/09
| Question | Answer |
|---|---|
| QUITS A FIXED SCREEN WITHOUT FILING OR SAVING | F7Q |
| INSERTS DATE/TIME STAMP ON COMMENTS SCREEN | F7D |
| JUMP TO PAGE PROMPT | F7P |
| INSERT MODE/INSERT A COMMENT | F8 |
| ACTIVATES ACTION CODES | F9 |
| SAVES INFO IN THE SYSTEM | F10 |
| REFRESHES SCREEN | F11 |
| NUM LOCK | ERASES AN ENTIRE FIELD |
| / | RESTORES AN ERASED FIELD |
| - | DELETES CHARACTERS TO THE RIGHT OF THE CURSOR |
| PAGE UP | MOVES TO PREVIOUS PAGE OF A FORM |
| PAGE DOWN | MOVES TO THE NEXT PAGE OF A FORM |
| BAR | BILLING AND ACCOUNT RECEIVABLE |
| PATIENT INQUIRY | FUNTION 49 |
| INVOICE INQUIRY | FUNCTION 7 |
| DICTIONARY INQUIRY | FUNTIONS 13,ACTIVITY5 |
| WHAT IS AN HMO | HEALTH MAINTENANCE ORGANIZATION |
| PATIENT MUST CHOOSE A PRIMARY CARE PHYSICIAN | HMO |
| PATIENT WILL REQUIRE AUTHORIZATION FOR NON PCP SERVICES AND TO SEE A SPECIALIST | HMO |
| OUT OF NETWORK SERVICES MUST BE PRE-AUTHORIZED | HMO |
| PATIENT RESPONSIBILITY IS LIMITED PRIMARILY TO CO-AYS OR NON COVERED SERVICES. | HMO |
| DEDUCTIBLE AND CO-INSURANCE DO NOT USUALLY APPLY | HMO |
| ALL HMO'S IN CALIFORNIA ARE REGULATED BY DMHC | HMO |
| PROVIVER ARE PAID A FIXED PER CAPITA(PER PERSON)AMOUNT FOR EACH PATIENT ENROLLED IN THE HMO OVER A STATED PERIOD OF TIME REGARDLESS OF THE TYPE AND # OF SRVCES PROVIDEDL | CAPITATION |
| WE CHARGE AFEE FOR SERVICE PROVIDED,SUBMIT A CLAIM AND RECEIVE PAYMENT BASE ON THE CONTRACTED RATE. | FEE FOR SERVICE/FFS |
| EXCLUSIVE PROVIDER ORGANIZATION | EPO |
| DO NOT HAVE OON BENEFITS/NEED TO SELECT PMG THAT IS IN NETWORK. | EPO |
| MUST UTILIZE IN NETWORK PROVIDERS IN ORDER TO RECEIVE BENEFITS. | EPO |
| ASSUMPTIONS OF LIABILITY | AOL |
| WHAT IS PP0? | PREFFERRED PROVIDER ORGANIZATION |
| DO NOT HAVE TO CHOOSE A PCP OR PMG.CAN SEE ANY PROVIDER,BUT PATIENT RESPONSIBILITY ISHIGHER IF THEY CHOOSE A NON PREFFERED PROVIDER. | PPO |
| DEDUCTIBLE,CO-PAYS AND COINSURANCE USUALLY APPLY. | PPO |
| NO REFERRAL OR AUTHORIZATION NEEDED TO SEE SPECIALIST.HOWEVER,AUTHORIZATION FOR CERTAIN SERVICES SOMETIMES IS REQUIRED. | PPO |
| WHAT IS A POINT OF SERVICE? | POS |
| A MEMBER MAY SELECT A DIFFERENT PROVIDER (AND BENEFIT TIER) EACH TIME THEY SEEK MEDICAL CARE. | POS |
| TIER 1 | HMO PLAN |
| TIER 2 | PPO PLAN |
| TIER 3 | INDEMNITY/COMMERCIAL PLAN |
| THESE ARE PATIENTS THAT COME TO SCRIPPS BUT BELONG TO ANOTHER MEDICAL GROUP | OON/OUT OF NETWORK |
| PATIENTS WHO COME FROM ANOTHER STATE AND SEEK TREATMENT | OON/OUT OF NETWORK |
| PATIENTS WHO WANT A SECOND OPINION FOR SERVICES THAT THEIR PMG HAS RECOMMENDED. | OON/OUT OF NETWORK |
| ANY TYPE OF INSURANCE THAT WE ARE NOT CONTRACTED WITH, | COMMERCIAL OR INDEMNITY |
| PATIENT IS RESPONSIBLE FOR ANY BALANCE AFTER INSURANCE. | COMMERCIAL |
| PATIENT MAY OR MAY NOT HAVE AUTHORIZATION REQUIREMENTS. | COMMERCIAL |
| STATEMENT PRODUCING FSCS. | COMMERCIAL |
| DEPARTMENT OF DEFENSEWIDE HEALTH CARE PROGRAM FOR ACTIVE DUTY AND RETIRED UNIFORMED SERVICES MEMBERS AND THEIR FAMILIES. | TRICARE |
| 65 YEARS OF AGE AND OLDER,CERTAIN YOUNGER PEOPLE WITH DISABILITIE; AND PEOPLE WITH END-STAGE RENAL DISEASE. | MEDICARE |
| A COVERAGE FOR ACUTE INPATIENT HOSPITALIZATION,SKILLED NURSING CARE,HOSPICE AND HOME HEALTH BENEFITS. | MEDICARE PART A |
| A COVERAGE FOR OUTPATIENT CLINIC MEDICAL BENEFITS. | MEDICARE PART B |
Created by:
BERNADETTE09
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