Patient Access 2016 Quiz

1. The patients insurance is Anthem. The patient's husband is the Subscriber. What patient relations should be selected?

Relative, Spouse

Child, Daughter

Patient, Patient

Other

The patient's insurance being Anthem indicates that the patient has a health insurance plan with that company. The fact that the patient's husband is the Subscriber suggests that he is the primary policyholder or the one who holds the insurance policy. Therefore, the patient and the husband have a spousal relationship, making the correct answer "Relative, Spouse."

Explanation

The patient's insurance being Anthem indicates that the patient has a health insurance plan with that company. The fact that the patient's husband is the Subscriber suggests that he is the primary policyholder or the one who holds the insurance policy. Therefore, the patient and the husband have a spousal relationship, making the correct answer "Relative, Spouse."

2. EMTALA (Emergency Medical Treatment and Active Labor Act) dictates:

A patient in the Emergency Department must be treated and stabilized regardless of their ability to pay.

All Emergency Department and Labor patients must be treated quickly.

You must get the patients ID and Insurance Cards before treatment is started to identify the patient.

None of these.

You will never ask for the Insurance Card(s) of any patient until they have been seen by a physician. We obtain their insurance upon full registration once cleared to go back.

Explanation

You will never ask for the Insurance Card(s) of any patient until they have been seen by a physician. We obtain their insurance upon full registration once cleared to go back.

3. A patient arrives for an outpatient appointment. As you verify the eligibility, you notice that the patient has Medicare part A only. His Medicare part B is inactive.How should the patient be registered?

Load the insurance as Medicare.

Load the insurance as Medicaid, then Medicare.

Load the insurance as Medicare then Medicaid

Load the insurance as Self Pay

Medicare part A is Inpatient only benefits.

Explanation

Medicare part A is Inpatient only benefits.

4. The patient in the ER is being registered. The patient hands the employee her Primary insurance and Secondary insurance card. The registrar did not do an eligibility check but it is okay to load the insurance.

True

False

You must complete an eligibility check for each patient's insurance card(s). You also must verify that it is active coverage. If not active you should remove the insurance. If the patient only has one insurance and it is inactive you still must remove the insurance and place as self pay. Be sure to note why it was removed!

Explanation

You must complete an eligibility check for each patient's insurance card(s). You also must verify that it is active coverage. If not active you should remove the insurance. If the patient only has one insurance and it is inactive you still must remove the insurance and place as self pay. Be sure to note why it was removed!

5. If a patient declines to give you their email address during registration you are allowed to enter it as [email protected].

True

False

If a patient declines to give you their email address or does not have an email address, this field should be left blank and simply noted in the free form notes section they declined to give.

Explanation

If a patient declines to give you their email address or does not have an email address, this field should be left blank and simply noted in the free form notes section they declined to give.

6. If a patient presents with with termed insurance you must _____________.

Place as self pay and place the termed insurance as secondary.

Keep the insurance loaded in case it gets back active.

Remove the insurance and place as self pay.

Keep the insurance loaded and note the account is termed.

Insurance must be ran on each patient. We have other tools to verify insurance such as ECARE. If the insurance is termed you must REMOVE the insurance and place as self-pay. You will also need to put a free text note in Star to indicated the changes. If you are unable to verify the insurance utilizing the insurance verification tools given, please escalate to your MGMT team for assistance.

Explanation

Insurance must be ran on each patient. We have other tools to verify insurance such as ECARE. If the insurance is termed you must REMOVE the insurance and place as self-pay. You will also need to put a free text note in Star to indicated the changes. If you are unable to verify the insurance utilizing the insurance verification tools given, please escalate to your MGMT team for assistance.

7. Conifer's Value's and Guiding Behaviors are....

Unity, Customer Service, Integrity, and Respect

Service, Unity, Leadership, and Avancement

Service, Guidance, Forgiveness, Compassion

Unity, Integrity, Service, and Respect

The correct answer is Unity, Integrity, Service, and Respect. These values and guiding behaviors reflect the core principles that Conifer upholds. Unity emphasizes the importance of working together as a team, while Integrity highlights the need for honesty and ethical behavior. Service underscores the commitment to providing excellent customer service, and Respect emphasizes the value of treating others with dignity and consideration. These values and behaviors are essential for creating a positive and supportive work environment.

Explanation

The correct answer is Unity, Integrity, Service, and Respect. These values and guiding behaviors reflect the core principles that Conifer upholds. Unity emphasizes the importance of working together as a team, while Integrity highlights the need for honesty and ethical behavior. Service underscores the commitment to providing excellent customer service, and Respect emphasizes the value of treating others with dignity and consideration. These values and behaviors are essential for creating a positive and supportive work environment.

8. If the patient does not know their employer address it is okay to leave blank as long as you have the name and phone number.

True

False

If they do not have their employers address we need to look it up on the internet to provide one. Not having the address will get percentages off your audit score.

Explanation

If they do not have their employers address we need to look it up on the internet to provide one. Not having the address will get percentages off your audit score.

9. A patient presents with a Medicare Card and a Passport Advantage Card. How would you load the insurance?

Passport Advantage only

Passport Advantage then Medicare

Medicare only

Medicare Part A Only.

When a patient present’s Medicare please prompt the question to ask if this is their only insurance or if they have a supplement or replacement plan. A lot of our errors come from them having a Medicare replacement and we have listed Medicare only or as Primary. With Passport Advantage Medicare should not be listed. This can not only cause problems for the patient being responsible for their bill but also hold payment for us. Running eligibility and ECARE will allow us to see additional coverage.

The only way to verify Passport Advantage right now is to call.

Explanation

When a patient present’s Medicare please prompt the question to ask if this is their only insurance or if they have a supplement or replacement plan. A lot of our errors come from them having a Medicare replacement and we have listed Medicare only or as Primary. With Passport Advantage Medicare should not be listed. This can not only cause problems for the patient being responsible for their bill but also hold payment for us. Running eligibility and ECARE will allow us to see additional coverage.

The only way to verify Passport Advantage right now is to call.

10. If you do not know the SSN of the patient or 999-99-9999 is entered what should we enter?

Nothing if it has 999-99-9999 already entered.

Ensure 999-99-9999 is entered.

Ensure 111-11-111 is entered.

None of the above

If the patient does not have their SSN 111-11-1111 needs to be entered. If 999-99-9999 is already there we need to update this information to 111-11-1111.

Explanation

If the patient does not have their SSN 111-11-1111 needs to be entered. If 999-99-9999 is already there we need to update this information to 111-11-1111.

11. Match the following