AAHAM CRCS Certification Chapter 3 - Patient Access / Front Office
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| show | Advance Beneficiary Notice of Noncoverage
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| What does HINN stand for? | show 🗑
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| show | Scheduling, Preadmission and preregistration, precert and preauth, registration and admission, insurance verification, financial counseling, collection, compliance.
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| show | Admitting, Patient In-take, or Registration
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| show | To act as a liaison between the physician and the patient.
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| show | customer service to improve initial pt impression, training staff to improve point of service collections, ensure admitting staff is well educated and can answer quest, identify ways to reduce wait times, preregistering pts, making process a positive.
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| show | Efficient patient scheduling.
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| How can efficient and effective scheduling help the entire office or hospital? | show 🗑
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| What can inefficient or ineffective scheduling cause? | show 🗑
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| What are the three elements that scheduling need to balance? | show 🗑
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| show | Patient demos (name, address, dob, SSN, etc), financial info, socioeconomic info.
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| Why should complaints decrease with the implementation of a preregistration program? | show 🗑
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| What other things can be done during preregistration? | show 🗑
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| show | Is an authorization provided by an insurance company review approving the medical necessity of the services.
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| What is authorization? | show 🗑
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| What happens when appropriate preauthorization is not obtained? | show 🗑
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| What information is helpful to obtain before seeing a patient in the office? | show 🗑
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| What is a guarantor? | show 🗑
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| show | A patient who has not received any professional service from that physician or any physician in a group practice within the past three years.
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| show | Pulling charts, preparing fee tickets, obtaining referrals for visits, obtaining preauth to see if a patient's insurance will cover a specific procedure.
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| show | A piece or paper or electronic version of when a patient's family provider, provides notice to the patient's insurance that the patient is obtaining care to a specific provider.
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| What responsibilities do the registrar have? | show 🗑
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| show | Greeting and checking the pt in, obtaining info for the pt info form, distribute required materials, check the patient out, maintain pt chart, verify ins eligibility, adhere to privacy requirements,
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| What does greeting and checking in patients include? | show 🗑
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| What materials are generally distributed during check-in? | show 🗑
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| show | Scheduling next appt, collecting financial obligations, completing requisitions for ordered tests, schedule an tests, obtain patient signatures as needed.
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| show | Filing of medical records, processing medical record requests, making sure any outside records are scanned into the facility's electronic medical records.
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| What questions should be addressed during insurance verification? | show 🗑
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| What tasks does financial counseling include? | show 🗑
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| What does the financial counselor do specifically for Facility? | show 🗑
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| What does DRG mean? | show 🗑
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| What does ALOS stand for? | show 🗑
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| show | Point of service
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| show | Collecting them at the time of service or POS
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| show | Yes
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| show | Preadmission, admission, in-house, at discharge, after discharge.
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| show | Preservice, Time of service, in-house, at checkout, post service.
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| show | True - Once the urgency is gone, patients are less inclined to pay their portion of the bill.
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| What is a deposit? | show 🗑
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| show | In one installment or financed over time. Can be collected prior to admission, at admission, or at discharge.
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| show | Increased hospital cash collections, reduced amount due at discharge, reduced overall accounts receivable, reduced financial risk and bad debt.
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| What are disadvantages of a deposit collection program? | show 🗑
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| show | It serves to prevent, identify, and remedy instances of fraud or abuse or other unacceptable conduct.
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| Does patient access have a key role in a compliant billing process? | show 🗑
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| show | Because the info entered during registration affects many other areas, and much of the data appears on the claim. Incorrect demographics can lead to fraudulent or abusive bills.
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| show | Important Message from Medicare, MOON, Guarantor forms, ABN, HINN,
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| show | Medicare Outpatient Observation Notice
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| What does ABN stand for? | show 🗑
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| What does HINN stand for? | show 🗑
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| show | It is a message from Medicare that hospitals are required to give all Medicare and Medicare Advantage beneficiaries who are hospital inpatients. Muse be issued within two days of admission and again within two days of discharge.
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| What is the MOON? | show 🗑
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| show | Notice of Observation Treatment and Implications for Care Eligibility
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| show | When pts are hospitalized for more than 24 hours if they are in observation status. No later than 36 hours after a patient begins to receive observation services, the pt must be informed, both orally and in writing of their observation status.
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| show | Beneficiaries - who do not have Part B coverage, who are admitted as inpatient prior to the required delivery of the MOON, for whom Medicare is either the primary or secondary payer.
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| Who does the MOON apply to? | show 🗑
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| show | Signed by the staff member. Must include the staff member name and title, that they presented the MOON, date and time. They must annotate the Additional Info section of the MOON.
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| show | It helps avoid having to write off claims that Medicare deems not "reasonable and necessary."
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| What is an ABN? | show 🗑
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| show | Before the service
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| show | Provider, Pt name and DOS, What the service is, Why provider things it is not covered, price of noncovered item, what the patient wants to do (their options), pt signature and date.
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| show | No.
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| Should every patient get an ABN? | show 🗑
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