PA/PFS Assessment

Mark all the correct anwsers: All of the following are charateristics of an MRN

Outpatient Account Number, please mark all the correct answers

Inpatient Account Number, please mark all the correct items.

Two Parts of SMS: THIS IS A DATABASE OF SMS THAT STORES ALL DEMOGRAPHIC AND INSURANCE INFORMATION. DEMOGRAPHIC UPDATES ARE STORED HERE. THE ABOVE STATEMENTS ARE DESCRIBING WHAT PART OF SMS?

Two Parts of SMS: THIS AREA OF SMS IS USED TO ENTER SMARTCARDS MESSAGES,POST INSURANCE AND PATIENT PAYMENTS,AND INSRUANCE AND PATIENT BILLING INFORMATION.

FUNCTION KEYS: Read the following description and select the corresponding function key. Insurance data, look at insurance information, start and stop dates of policy, last payment from insurance listed.

FUNCTION KEYS: Read the following description and select the corresponding function key. Detail Summary: Look up all payments (insurance & patient’s), adjustments and types of charges by department (ex: pharmacy, radiology, pathology, clinical charge)

FUNCTION KEYS: Read the following description and select the corresponding function key. Select Account Detail: Search account by transactions (charges, adjustments, payments, comments, balance transfers and late charges). You can also search by service/post date

FUNCTION KEYS: Read the following description and select the corresponding function key. Account Detail: View all transactions posted within 180 days.

FUNCTION KEYS: Read the following description and select the corresponding function key. Unit Summary: View unit details by unit dates/service dates

FUNCTION KEYS: Read the following description and select the corresponding function key Post Comments: Enter smartcard message and send referral messages

FUNCTION KEYS: How do you suspend the current workflow in SMS?

Function Keys: Which listed process is the correct way to access the HELP screens in A2K?

Adjustments: This is an example of an _________________

121008 121008 37560 53 08/31/08 ALLOWANCE MULTIPLA -149.90

Adjustments: This is an example of an _________________

062008 111708 805358 67 04/19/08 CHARITY CARE PATIE -654.00

Adjustments: This is an example of an _________________

110908 111808 470021 14 04/30/08 NY STATE SURCHARGE 1979.59

Adjustments: This is an example of an _________________

120108 120208 525550 24 12/31/08 CO-PAY RX M957136 10.00

Adjustments: New York State Surcharges and an RX Copay's are adjustments because ______________________

Contractual agreement between MSK and Insurance for charges/claims to be paid at certain rates. What is this the definition of?

Patient Balance: Patient Responsibility includes
(choose all that apply)

Each carrier determines the rate that they will pay for each service. This is the definition of?

Fill in the blank: Patient Balance
If MSK is an Out of Network (OON) provider, then the ________ will be responsible for the OON responsibilities and the difference between MSK’s charge and the reimbursement UCR rate from the insurance carrier

What is a unit? Choose all that apply.

Please refer to your provided sheet. Thinking about MRN 1. Provided unit date 01/12/15. What is the service date?

Please refer to your provided sheet. Live SMS. Thinking about MRN 1. Provided unit date 01/12/15. Name of insurance billed 02/12/15.

Please refer to your provided sheet. Thinking about MRN 1. Provided unit date 01/12/15. Total charge amount billed to Insurance on 02/12/15.

Please refer to your provided sheet. Thinking about MRN 1. Provided unit date 01/12/15. What was the first Insurance payment received (Date paid and amount)

Please refer to your provided sheet. Thinking about MRN 1. Provided unit date 01/12/15. What is the patient's responsibility for this unit?

Please refer to your provided sheet. Thinking about MRN 1. Provided unit date 01/12/15. Thinking about the patient's responsibility, what are the names of the items that are causing this balance?

Please refer to your provided sheet. Thinking about MRN 1. What is the total account balance for the active outpatient account?

Thinking about MRN #1 sd 01/12/15. Please pull up the ERA from the payment received 10/15/15 showing the patients deductible and copay liability. Enter the document id below.

RAM: Name that RAM Doc Type!
Patient has Medicare insurance and you want to check if a TEFRA form has been completed. What Doc type is the patient's TEFRA form scanned under?

RAM: Name that RAM Doc Type!
Patient calls to see if we have the latest insurance card on file What Doc type is the patient's insurance card scanned under?

RAM: Name that RAM Doc Type!
Patient is registered and signs a Guarantee of Account (GOA) & Release of Information (ROI) form. What Doc type is this document scanned under?

RAM: Name that RAM Doc Type!
Individual insurance voucher for a payment received from Commercial Insurance.What Doc type is this document scanned under?

RAM: Name that RAM Doc Type!
Patient’s son is calling to discuss patient’s account and you want to see if he is authorized. What document would you use to confirm if he was authorized?

Patient Balance: Patient Responsibility includes (Select all that Apply)

This is the description of what type of charge?
•Includes charges for the physician’s time
•Also includes clinical psychologists, nurse practitioners (NP) or certified registered nurse anesthetist (CRNA)
•Examples: New Visit appointment, Follow up appt, Performing a procedure, interpretation of test results, Supervision of fellows/residents
•Enter in PBD Billing System, IDX

This is the example of what type of Charge?
•Often called the technical charge
•Includes charges for all services rendered by the hospital other than physicians
•Examples: Pharmacy, Inpatient admission, Room and Board, Supplies, Purchases and Maintenance of equipment, Radiology, Labs, Surgery time
•Enter in the Patient Accounts Billing, SMS