Job Function Module Relates to Job Task Lesson Learning Objective Training Method Assessment Time Location of Each Group, Divisions, Billing Areas

Transcription

1 Page 1 of 6 MSKCC Location of Each Group, Divisions, Billing Areas Manhattan Locations By the end of this lesson, you will have developed a basic knowledge of each Manhattan location and the specific services provided to patients at each location Classroom, Visual Aids Group Activity: Given a map of Manhattan you will be able to locate each MSKCC location and list 2 patient services in each building. PBD Patient Registration Charge Creation to Claim Submission From the Insurance's Response of Claim to Payment or Write off Location of Each Group, Divisions, Billing Areas Location of Each Group, Divisions, Billing Areas Regional Locations Patient Care, The Best Anywhere By the end of this lesson, you will have developed a basic knowledge of each regional location and the specific services provided to patients at each location. At the conclusion of the lesson you will be able to discuss the types of treatment patients receive to cure their cancer at MSKCC. How to Identify a patient Identifying a patient At the conclusion of the lesson you will be able to identify an MRN and its meaning at MSKCC. Identify each field of an Divisions and Billing At the conclusion of the lesson you will be able to identify the divisions and billing areas of invoice Areas MSKCC and explain their hierarchy. Identifying the correct case for an invoice Identifying the correct case for an invoice How we receive patients insurance information Identifying the fields on a claim, how we receive patient insurance information Reading FSC List, F/U work, AR work, Denials Physician Billing vs. Hospital Billing Inpatient vs. Outpatient How Patients Register Collecting Patient Demographics Types of Managed Care Plans By the end of this lesson you will be able decipher which kind of charges are billed by physician billing and which are collected by hospital billing. After completing this you lesson, you will be able to decipher which kind of charges are inpatient and which kind of charges are outpatient. After completing this lesson, you will be able to identify how each step a patient takes to register at MSKCC relates to the billing process. At the conclusion of the lesson, you will be able to recall all necessary patient demographics needed for the billing process gathered at PFS. After completing this lesson, you will be able to identify the key characteristics of each kind of managed care plan. Insurance The Insurance Card By the end of the lesson, given a patient's insurance card you will be able to cite the insurance terms related to each field on the card. Insurance, Reading Charge Tickets, EOB's, Claim forms Insurance, Reading Charge Tickets, EOB's, Claim forms how to apply appropriate paycode/fsc how to apply appropriate paycode/fsc Insurance, Reading Charge Tickets, EOB's, Claim forms Understanding from claim creation to write off/payment Charge Creation to Claim Submission Insurance Process From the Insurance's Response of Claim to Payment or Write off Secondary Billing Insurance Process Job Functions in PBD describe each step of the PBD process from the time of patient registration to claim submission. By completing this lesson you will be able to define basic insurance concepts terms and apply them to PBD's Billing Process. Classroom, Visual Aids Case, Structured Activity w/discussion, Video Classroom, Game Reading, Visual Aids, Game Classroom w/job Aid, Game Classroom w/job Aid, Game Classroom, Game Demonstration, Role Play Demonstration, Role Play Classroom, Visual Aid, Note Taking w/job Aid (do patient tour?) Reading w/job aid Case list each step of the PBD process from the time Classroom, Game (like Scavenger Hunt to follow of insurance company response to the claim until the payment or write off. a claim?), Discussion apply how PBD handles the secondary billing process. By completing this lesson you will be able to define basic insurance concepts terms and apply them to PBD's Billing Process. By the end of this lesson you will be explain how each operational job function in PBD relates to each other within the billing process. Classroom, Job Aid with note taking, Case Reading w/job aid, Case Classroom, Visual Aid, Note Taking w/job Aid (do patient tour?) Group Activity: Given a map of the tri-state area you will be able to locate each MSKCC location and list 2 patient services in each building. Group Activity: Given a type of cancer using the website you will be able to explain the kind of cancer and possible types of treatment for that cancer Individual: Given a list of 10 MRN's you will be able to choose which are valid for MSKCC. Group Activity: Given a division, you will be able to match the billing areas that are a part of the division. Individual: Given a list of types of charges you will be able to correctly match whether they are physician charges or hospital charges. Individual: Given a list of types of charges you will be able to correctly match whether they are inpatient charges or outpatient charges. Group Activity: Given a list of each step of the PAS-PFS process you will be able to put them in the correct order and relate to the billing process. Group Activity: Given a list of patient demographic information you will be able to correctly pick which information MSKCC collects at registration Group: Given a list of managed care plan characteristics you will be able to match them to the correct plan type. Individual: Provided with a copy of 5 patients insurance cards you will name each filed using the proper insurance term. Group Activity: Provided with each step from patient registration to claim submission you will put them in order and verbally describe the process. Individual in CBT: Provided with a list of basic insurance terms you will be able match the correct definition 80% of the time Group Activity: Provided with each step from the Insurance Response to Claim to Payment/Write off you will put them in order and verbally describe the process. Individual: Given 5 written scenarios of patient billing you will list the next steps for the secondary process for each. Individual in CBT: Provided with a list of basic insurance terms you will be fill in the correct definition 80% of the time Individual in CBT: Given a list of steps in the billing process you will be able to correctly state how each job function fits in this process

2 Page 2 of 6 Insurance Companies How Government insurance Medicare/Medicaid After completing the lesson, you will be able to compare Medicare, Medicaid & Tricare by Classroom, w/ Job Aid Individual: You will list 3 main characteristics of Government Run Works, Insurance listing the main characteristics of each insurance. Medicare and 3 main characteristics of Medicaid Insurance How Government insurance Works, Insurance How Government insurance Works, Insurance Medicare/Medicaid Terms Government Insurance Process w/in PBD define the key terms of the Medicare/Medicaid process and write a paragraph explaining the process correctly. Classroom, w/ Job Aid After completing this lesson, you will be able to recall the special rules followed in PBD Case, Discussion w/group activity regarding the Governmental Insurance Processand apply them to a patients billing process. Group Activity: Given a list of Medicare terms you will write a paragraph explaining the Medicare billing process. Individual: Given 5 written scenarios of patient billing situations you will list the next steps in the process for each. Commercial Insurance How Private Insurance works, Insurance IDX Structure & Navigation Location of Each Group, knowing the regional centers/finding them in IDX MSKCC's Contracts Functions of BAR & PCS locate contract information for PBD commercial insurance and name 5 commercial insurance companies we participate with. At the conclusion of the lesson, given a list of IDX functions you will be able to categorize what work is done in BAR vs. PCS and what each function does. Case, Classroom w/job Aid Classroom, Case Individual: Given 10 patients with commercial insurance you will locate on the shared drive the contract info sheet and will correctly determine which insurance is contracted with MSKCC. Individual: Given a list of all the functions of BAR and PCS you will match each function to the correct part of IDX How to navigate in IDX Group Organization At the conclusion of the lesson you will be able to recall the name of each group in IDX and how they are numerically symbolized. How to navigate in IDX Logging in to IDX At the conclusion of the lesson you will be able define the specific vocabulary used to function in IDX How to navigate in IDX Keystrokes In IDX After completing the actives you will be able to demonstrate the IDX specific key strokes by moving through IDX menus and screens. Classroom, Case Demonstration, Training UCI Classroom, Case Group Activity: Given a map of the tri-state area you will be able recall the group number and location for each MSKCC group. Individual in CBT: Provided with a list of IDX terms you will be able match the correct definition 80% of the time Individual in IDX: Given a list of activities in IDX that move you through the software correctly execute each one FSC IDX Menus How to navigate in IDX Editing in IDX fields At the conclusion of the lesson, you will be able to demonstrate the ability to edit information given a list of IDX fields to edit., Training UCI Individual in IDX: Given a list of activities in IDX to edit you will correctly execute each one How to navigate in IDX, At the conclusion of this lesson you will be able to use each method to identify a patient in Demonstration, Training UCI Individual in IDX: Given a list of different kinds of HIPPA Identifiying a Patient IDX and use them to look up patient accounts. patients demographic information you will look up Meaning of FSCS Characteristics of FSC's explain the key characeristics of FSC's. Demonstration, Training UCI Inidividual in CBT: Given a FSC list you will deceipher the key characteristics of FSC List. Meaning of FSCS, picking the right FSC Insurance Company FSCs Meaning of FSCS, picking FSC List the right FSC Meaning of FSCs, when to FSC List write-off an invoice balance Meaning of FSCs, deciphering which FSC is active on an invoice How to navigate in IDX, FSC Hierarchy picking the right FSC How to navigate in IDX, Registration Looking up invoice inquiries identify the most common insurance FSCs by its mnemonic. Classroom, Case Individual in CBT: Provided with a list insurance companies and 15 FSCs you will be able to recall what each FSC stands for. Group: Given 10 scenarios idenitify how the FSC will move through the invoice. Group in IDX: Given a screen shot you will explain what each field means. By the end of this lesson you will be able to describe the rules of how FSC's move through Classroom, Case an invoice. By the end of this lesson, given a FSC list you will be able to define the meaning of each Classroom, Case field. FSC Transfers At the conclusion of this lesson, you will be able to change the FSC on an invoice in IDX., Training UCI Individual in CBT: Given different IDX screens you will deciper it what situations a FSC can be changed.. At the conclusion of this lesson you will be able to state in what screens you can change the FSC on an invoice in IDX. At the conclusion of this lesson you will be able to locate the registration screens in IDX and locate the information found in those screens. Individual in CBT: Given 10 written scenarios of patient billing situations you will decide what is the next active FSC. Individual in IDX: Provided with a list of 5 patients you will locate their registration information and answer questions about their demographics. 1 How to navigate in IDX, Resources in IDX, looking up paycode, FSC, User id Invoice Inquiry By the end of this lesson, given an invoice in IDX you will be able to identify each field in the invoice inquiry screen and explain what the field means. Classroom, Note Taking w/job aid Group in IDX: Given a screenshot and a list of fields you will identify each one correctly. Opening a CE or PP Batch Dictionaries At the conclusion of this lesson, given a list of insurance concept information you will be able to distinguish which IDX dictionary you would find the information. Creating CE or PP Batch Balancing a Batch explain the relationship between control, actual and difference when completing a batch screen., Game Show, Discussion Individual in IDX: Provided with a list of insurance concept information and a list of the IDX dictionaries you will locate each one in the correct IDX dictionary. Group Activity: Identify which batches are out of balance given the control, actual and difference.

3 Page 3 of 6 Creating Batches Charge Entry Enter Charges, Claim Submission, Charge Correction Anatomy of a Charge Ticket By the end of the lesson given a charge ticket you will correctly identify each field and the rule of each field., Training UCI Individual: Given 10 charge tickets correctly identify which tickets would be rejected. Creating CE Batch Batch Hash Charge Entry At the conclusion of the lesson you will be able to recall how to determine the hash of a charge entry batch and then given a batch correctly add the hash total Classroom, Note taking w/job Aid Individual: Given 5 batches of charge tickets correctly add the hash for each one. Creating CE or PP Batch Charge Entry Action Fields By the end of the lesson, you will be able to state and describe the function of each action code in the batch screen Individual in CBT: Given each action code correctly match it to its function. Charge Entry Explaining statement to patients Creating CE or PP Batch Entering Charges Filling out a Batch Header At the conclusion of this lesson, you will be able to enter outpatient and inpatient charge tickets into the IDX System After completing the lesson, given specifics for a CE batch you will be able to enter each field batch correctly in IDX., Training UCI Individual in IDX: Given 10 batches in IDX correctly enter each charge. Individual in IDX: Given all necessary information you will complete 9 out of 10 batches correctly Claim Submission Charge Interface By the end of the lesson, you will be able to explain how charges come to IDX via charge interface. Classroom Written Assignment: Explain Charge Interface Completing CE or PP Batch End of Day Batch Processing At the conclusion of the lesson, you will be able to summarize how batches are processed at the end of each day and month. Group Activity: Correctly explain the process that happens each day and each month to batches. How to charge tickets Batch Maintenance At the conclusion of this lesson, you will be able to recognize the screens within batch maintenance that are necessary to check your daily work. Claim Submission When Batches Go Bad At the conclusion of the lesson, you will be able to determine when there was a mistake in a batch and how it would be fixed correctly., In Basket Game Classroom, In Basket Game Individual in IDX: Given a batch find all necessary information need to ensure all transactions are correct. Individual in IDX: Given an examples of incorrect batches, correctly identify the mistake and state how it will be correct. Individual in Outlook: Given 5 folder names used in job function you will create them in Outlook. Communication Folders By completing this lesson you will be able to create and organize the folders in your outlook Demonstration inbox. Outlook Communication Writing s Create s that illustrate clear and professional language. Demonstration Individual: Given 5 written scenarios write a clear and professional Communication Creating Events Create events on your calendar Classroom, Case Individual: Given 3 examples of events, correctly add to your calendar. Security, HIPPA Flags The use of flags for prioritization. Individual: Given a list of s and what priority they are in correctly attach the flags. Security, HIPPA Policy and Outline the MSKCC policy and list what actions are not allowed over MSKCC . Classroom Individual: Given 5 written scenarios of s Procedure correctly identify as appropriate or inappropriate. Group: Given a list scenarios choose which s should have additional security. Time Management & Prioritizing Prioritizing Work, Getting it all done Prioritizing Work, Getting it all done Time Management At the end of this lesson you will be able to describe the importance of time management. Classroom Group: You will describe two scenarios where time management is important. How to Prioritize Tasks Define a strategy to set priorities. Classroom, Group work/game Group: Give a list of priorities you will use at least one new strategy to prioritize them Active Listening Teamwork Prioritizing Work, Getting it all done Working with coworkers/management, better phone skills Working with coworkers/management, better phone skills Working with coworkers/management, team meetings Working with coworkers/management, team meetings How to Prioritize Tasks Apply time management tips to complete your specific daily job functions. Classroom, Case Group: Provided 5 scenarios for your job functions you will be able to prioritize the tasks and explain why you prioritized it that way. Active Listening and Communication Active Listening and Communication Define active listening and its relationship to communication Classroom, Group work/game Group: You will describe 2 key characteristics of active listening Engage in and model active listening skills Classroom, Case Group: Through role play you will correctly use active listening in situation pertaining to your job function. Teamwork Define PBD expectations for a team player Classroom, Group work/game Individual: You will identify and explain the various components necessary to a sucessful team player in PBD. Teamwork Engage and model team player characteristics. Classroom, Game Group: Through role play you will correctly use teamwork in situation pertaining to your job function. - Earthquake game

4 Page 4 of 6 TOTAL Except Charge Entry HOLDING FSCs and Optical Identify Holding FSCs, Work Rejections, Appeals and A/R Explain how holding FSC's are used, Work Rejections, Appeals and A/R Identifying Holding FSCs By the end of this lesson you will be able explain how holding FSCs are used by citing specific FSCs and illustrating examples of usage Classroom, Discussion CBT: Provide 5 scenarios select which FSC is appropriate for each scenario COORDINATION OF BENEFITS Work COB Report. Explain Reviewing Coordination how coordination of Benefits of Benefits work. Work Rejections, Appeals and A/R By the end of this lesson you will be able to explain the primary steps to resolve a Coordination of Benefits issue. Classroom Written Assignment: Explain what coordination of benefits means. POSTING PAYMENTS Recievables Edge PA SMS COMPUTER SYSTEM Posting GUR Payments, How to Post Line Item Payments, Posting Payments via Receivable's Edge Posting GUR Payments, How to Post Line Item Payments, Posting Payments via Receivable's Edge Creating a batch header in PP Source of Payments identify which insurance carriers send payments via paper check or EFT/835. How to identify the Given the source of payment, you will be able to identify the correct payment code to use Appropriate Paycode when posting payments 80% of the time when Posting Payments Creating a Batch and Completing the Batch Header By the end of this lesson you will be able to create a new batch and complete the Batch Header with no errors Opening a CE or PP Batch Payment Posting At the conclusion of this lesson, you will be able to recognize the payment posting screen and describe the action code functions Posting GUR Payments, identifying a PP reference number Identifying a PP reference number, Read an EOB, Identify an Invoice on an EOB. Posting Guarantor Payments Reading and Using Information on an EOB How to Post Line Item How to Post Insurance Payments, Identifying a PP Payments reference number Identifying a PP reference number. Looking up an EOB/Check. How to Post Line Item Payments. Using SMS Using SMS Using SMS How to use Receivable's Edge Access and Patient Inquiry Overview Review Insurance Information Reviewing Account Details Provided the guarantor's payment information, the trainee will be able to enter guarantor payments into IDX 80% of the time By the end of this lesson you will be able to use the EOB to identify: patient's account, invoice, procedure code and payment amount in IDX. By the end of this lesson you will be able to enter Insurance payments into IDX via line item. Given the minimum amount of information needed to look up a payment in RE, the trainee will be able to look up payments to post into IDX 80% of the time. By the end of this lesson you will be able to demonstrate how to access SMS in order to use the four patient inquiry functions to pull up patients. By the end of this lesson you will be able to demonstrate how to interpret insurance information in SMS. By the end of this lesson you will be able to interpret SMS smart cards in order to be know the activity on an account. Discussion, Case Classroom, Provided with a list of Insurance Carriers, you will select which carriers send payments via check and which send payments via EFT/835. CBT: Provide ten sources of payments/scenarios select which paycode is appropriate for each scenario. Provided (5) scenarios, post each payment in IDX. Individual in CBT: Given a list of functions you will correctly identify which are functions of payment posting. Classroom, Given 5 EOB's, trainee will need to answer 15 questions related to the information on the EOBs. Demonstration Provided (5) scenarios, post each payment in IDX. Provided (5) scenarios, post each payment in IDX. Provided (5) patients, look up each patient using a different Patient Inquiry Method. Provided (5) patients, look up each patient's FSC List and note what insurance is primary and secondary for each patient. Given (5) patients, you will access the account detail, write out what the smart card is telling you. Choose one patient write-up and explain to the class what the notes indicate. Using SMS Reviewing Authorizations By the end of this lesson you will be able to demonstrate how to find authorization. By the end of this lesson you will be able to interpret the aspects of the authorization screen. Given (5) patients, you will access the account and pull up the authorization status. Then you will explain to the class whether there is an authorization on file on how you reached your conclusion. TOTAL 10.00

5 Page 5 of 6 PAPERLESS Workfiles explain the following: Definition, Types, Batch CBT: You will answer 10 questions about workfiles. COLLECTION SYSTEM Options and Access Options. By the end of this lesson you should be able to use at least 3 (PCS) methods to look-up a patient in PCS. Audit, AS, GIS, CIS, Accounting Exploring Access Work-file Options, Define work file and explain the different types of work files, Review PCS work file options Define item and explain the purpose of item statuses, Explain how work files are created, Finishing an Item and exiting the workfile, Explain how items qualify/sort into workfile. Review PCS Action Codes, Accessing BAR Data/Functions via PCS, Describe what action codes are and how they are used Items By the end of this lesson you will be able to explain how the following works in your job: Definition, Compilation, Qualification and Sorting Criteria. Classroom, Case CBT: You will answer 10 questions about items. Action Codes By the end of this lesson you will be able to use PCS action codes to document an account. Classroom Given 10 written scenarios, you will note PCS CLAIMS & INVOICES Review PCS History PCS History By the end of this lesson you will be able to summarize the activity on a patient's account. Demonstration, Discussion, Case Given a patient, you will access PCS History and explain the PCS notes to the class. Demonstrate how to Overview of Queuing a demonstrate how to print. Queue and re-queue Provided 3 scenarios, you will print, queue and requeue demand/requeue a claim Claim a claim form. a claim. form CHECKS & REFUNDS Claim Edits Claim Edits By the end of this lesson you will know what a claim edit is, how to identify a claim edit on an invoice, and be able to list the different types of edits. Review Invoice detail and More Header Invoice. Impossible Check Find Overview of Invoice Detail & More Header Information How to Execute a Check Find interpret all the information displayed within the Invoice Detail and More Header Information. Given the minimum amount of information needed to look up a payment, you will be able to demonstrate how to execute a check find 80% of the time. Demonstration, Games & other Structured Activities Written Assignement: Explain what a claim edit is. Explain how to find a claim edit on an invoice. List and describe 2 claim edits. Provided an account, you will explain to the class the activity posted to the invoice. In addition, provided a worksheet, you will look up an invoice Provided 2 check numbers, you will execute a check find to locate the payments. RAM HEALTHCARE INFORMATION SYSTEM (HIS) ADJUSTMENTS Guarantor Refunds Guarantor Refunds By the end of this lesson you will be able to complete an adjustment form for Guarantor Refunds. Reading Material, Discussion, Demonstration, Case Insurance Refunds Insurance Refunds By the end of this lesson you will be able to complete an adjustment form for Insurance Reading Material, Discussion, Demonstration, Refunds. Case Use of RAM Overview of RAM By the end of this lesson you will be able to search for various documents in RAM such as a charge ticket, batch proof, patient waiver or appeal. Use of RAM How to Look Up Various Demonstration, Job Aides Documentation Use of HIS Overview of HIS navigate through the HIS system and demonstrate how to look up E-medical records for a patient. Moving money between Transfers invoices, groups and collections Reversing c/a, reversing Reversals incorrect finacial transactiosn Meaning of FSCs, Write-off FSCs deciphering which FSC is active on an invoice Write off due to Write Offs rejections/appeals/collection s Write off due to Reverse Write offs rejections/appeals/collection s identify when to transfer money between invoices/groups and post the transfer. identify when and how to reverse money between invoices/groups and post the transfer. Demonstration, Simulations Demonstration, Simulations Given 10 invoices, you will fill out an adjustment form for each. Given 10 invoices, you will fill out an adjustment form for each. Given a worksheet of 10 questions, you will look up various documents in RAM and answer the questions listed on the worksheet. Given 3 invoices, you will access HIS and locate the medical records for the specified dates of service (Instructor will note PCS in LIVE w/amr Action code stating HIS training). Given (10) invoices that have credits you will resolve each invoice and note PCS accordingly. Given (10) invoices that have credits you will resolve each invoice and note PCS accordingly. explain what a writeoff is and agive 5 examples Individual in CBT: Given a list of FSCs identify 10 of how they are used. scenarios when a write-off occurs in our systems. By the end of this lesson you will be able to identify when and how to post a write off for both an entire invoice and a line item. By the end of this lesson you will be able to identify when and how to post a reverse write off for both an entire invoice and a line item. Demonstration, Simulations Demonstration, Simulations Given (10) invoices that have credits you will resolve each invoice and note PCS accordingly. Given (10) invoices that have credits you will resolve each invoice and note PCS accordingly

6 Page 6 of 6 TOTAL AS, GIS, CIS call INS company, calling What is Good Phone Define MSKCC standard for phone skills and its relationship to active listening Classroom, Case Group: You will describe 2 key characteristics of Phone Skills other depts, calling patients Skills? MSK standards for phone skills. call INS company, calling Applying Phone Skills to Engage in and model MSKCC phone skills Classroom, Case Group: Through role play you will correctly use 2.00 other depts, calling patients your Job. phone skills in situation pertaining to your job function. CLAIMS: IN DEPTH Identify the fields on a claim and explain how it's created. Claim Form Dissection interpret the different fields on a claim form. Classroom, Case CBT: Given a claim form, you will answer 15 questions. COMPLIANCE DATABASE Determine how to resolve rejection, Follow up on Appeals, Verify FSC List Use of Compliance Database Reviewing the FSC List How to Use the Compliance Database Given a FSC List, you will be able to identify whether or not a FSC List is correct or needs verification 80% of the time. Classroom, Given 5 FSC lists, you will select which are correct and incorrect. For the incorrect ones, write out what needs to be done in order to rectify the FSC Lists. By the end of this lesson you will also be able to demonstrate how to enter an inquiry. Provided a screenshot of the Compliance Entry Database and given a scenario, you will fill out the screenshot indicating what information they REJECTIONS Verify Rejection or Denial Posting Rejections post any rejection in IDX. In IDX, provided (10) written scenarios, you will post each rejection. Determine how to resolve Processing Rejections By the end of this lesson you will be able to resolve the most common rejections. Demonstration, Discussion, Case Given (10) rejected invoices you will explain how rejection, Verify FSC List (IS only) to resolve each rejection. APPEALS Specialist Appeals Submitting an Appeal submit an appeal package for nongovernmental Classroom, Given (3) written scenarios, you will execute an Package carriers. appeal package. insurance inquiries Insurance Follow-up follow up on any issue with an insurance Classroom, Role-Play Group: Through role play you will correctly use carrier. phone skills in situation pertaining to your job function that involves insurance follow up. CHARGE CORRECTIONS Charge corrections w/o payments Charge corrections with payments Charge Corrections without Payments (include CE, Audit) Charge Corrections with Payments Attached (include CE, Audit) By the end of this lesson you will be able to enter a charge correction for invoices without payments attached 80% of the time. By the end of this lesson you will be able to enter a charge correction for invoices with payments attached 80% of the time. Given (5) written scenarios, you will execute each charge correction in IDX. Given (5) written scenarios, you will execute each charge correction in IDX Charge corrections with rejections or $0 payments. Charge Corrections with $0 Payments Attached, (include CE, Audit) By the end of this lesson you will be able to enter a charge correction for invoices with $0 payments attached 80% of the time. Given (5) written scenarios, you will execute each charge correction in IDX. TOTAL 16.50

7 Job Function AS INQUIRIES & FOLLOW-UP COMMENTS & UPDATES Module Tasks Lesson Learning Objective Training Method Assessment Time ELECTRONIC PAYMENTS (QUICK PAY) PA/PBD PORTAL Automated Call Distribution Patient Inquiries Non-PBD Inquiries Accessing & Editing General Comments Demographic Updates Insurance Updates Sending out Patient Statements Using Epay System Using the PA/PBD Portal How to use the Automated Call Distribution Line Patient Inquiries and Follow-up Non-PBD Inquiries and Follow-up Accessing and Editing General Comments Demographic Updates Insurance Update Form (IUF's) How to Demand a Patient's Statement How to Use Quick Pay Credit Card Disputes How to Use the PA/PBD Portal use the ACD Line to answer Patient Telephone Inquiries address the most common issues with a patient on the phone. address the most common issues with any Non-PBD Department. Given (5) sample scenarios, you will be able to access and edit general comments for each patient with no errors. Given (5) sample scenarios, you will be able to access and edit each patient's demographic information in IDX. By the end of this lesson you will be able to complete an insurance update form with no errors. demonstrate how to print a patient's statement with no errors. explain the purpose of the Quick-Pay website. demonstrate how to use the Quick-Pay website. demonstrate how to resolve credit card disputes. demonstrate how to use the PA/PBD Portal to locate information regarding the Patient's Physician/Hospital bills. Classroom, Demonstration/Observation Using the live ACD Line, the specialist will demonstrate how to use the system to receive a patient inquiry. Presentation, Role-Play Group-Activity, Role-play (Fish Bowl) 3.00 Classroom, Role-Play Group-Activity, Role-play (Fish Bowl) Demonstration, Case study Demonstration Provided a written scenario, access & edit general comments in IDX. Provided (3) written scenarios, you will edit demographic information in IDX. Given (3) written scenario and provided IUF Form, you will complete the form. Given (3) patients, you will print a statement for each. Written Assignment: Discuss various ways to resolve credit card disputes. Written Assignment: Explain the purpose and use of the Quick-Pay site. Given a sample patient, you will use the PA/PBD Portal to answer 10 questions listed on a worksheet FINANCIAL EVALUATION Describe the FE Process Explain the Financial Evaluation Process thoroughly explain the F.E. program to a patient or third party. Classroom Written Assignment: Explain the Financial Evaluation Process.

8 Job Function Module Tasks Lesson Learning Objective Training Method Assessment Time MEDICAID WEBSITE REPORTS Use of the Epaces website Deceased Report Deceased Report How to Use the Medicaid Website to verify eligibility Deceased Report demonstrate how to use the Medicaid website. Given (5) deceased patients, you will be able to demonstrate how to process these patients with no errors Case Given (3) Medicaid Patients, you will use the website to verify eligibility. Given (3) deceased patients, you will process each patient accordingly based on the process for working the Deceased Report. Guarantor Report Guarantor Report Guarantor Report Given (5) sample patients, you will be able to demonstrate how to process these patients with no errors. Given (3) patients, you will process each patient accordingly based on the process for working the GUR Report. PTP Report PTP Report PTP Report Given (5) sample patients, you will be able to demonstrate how to process these patients with no errors. Given (3) patients, you will process each patient accordingly based on the process for working the PTP Report. Expired FSC Report Expired FSC Report Expired FSC Report Given (5) sample patients, you will be able to demonstrate how to process these patients with no errors. Given (3) patients, you will process each patient accordingly based on the process for working theexpired FSC Report. Monthly Report Monthly Report Monthly Report Given (5) sample patients, you will be able to demonstrate how to process these patients with no errors. Given (3) patients, you will process each patient accordingly based on the process for working the Monthly Report. TOTAL * NOT ALL - AS ONLY?* Patient Statements Explaining statement to patients Explaining statement to patients Patient Statements Patient Statements By the end of the lesson given a patient statement you will explain where this information is pulled from IDX. By the end of the lesson given a patient statement you will identify the fields on a statement. Classroom, Notes w/job Aid, Group Activity Classroom, Notes w/job Aid, Group Activity Individual: Given 5 patient statements correctly identify the information in each field. Group Activity: Given 5 patient statements correctly identify where the information came from in IDX. TOTAL 3.00

9 Job Function Module Tasks Lesson Learning Objective Training Method Assessment Time GIS WNS APPEALS Processing WNS Appeals Preparing an Invoice for WNS Appeal By the end of this lesson you will be able to, Given (5) written scenarios, you will note PCS demonstrate how to note PCS for an invoice to be appealed by WNS. Case accordingly for indicating a WNS appeal. MEDICARE WEBSITE INVOICE SPLITTING Processing WNS Appeals Exception Processing WNS Appeal Exceptions By the end of this lesson you will be able to process a WNS Appeal Exception. Using the Medicare Website Using the Medicare Website How to Use the Medicare Website Splitting Invoices for Partially paid Medicare Charge Corrections by Invoice Splitting claims By the end of this lesson, you will be able to explain when best to use the Medicare website. By the end of this lesson, you will be able to demonstrate how to use the Medicare website. By the end of this lesson you will be able to enter an invoice split for invoices with payments attached 80% of the time. By the end of this lesson, you will be able to process the 90 Day report. Classroom, Case Written Assignment: Explain what a WNS Appeal Exception is. List 3 different kinds of appeal exceptions along with how they would be resolved. Given (3) written scenarios, you will use the Medicare Website to resolve each scenario. 90 DAY REPORT 90 Day report How to Process the 90 Day Report Classroom, Case Given (5) written scenarios, you will execute each invoice split in IDX. Written Assignment: How do you process an item on the 90 Day report. TOTAL 4.50

10 Lesson Learning Objective Training Method Assessment Time Posting GUR refunds By the end of this lesson you will be able to enter a GUR Refund 80% of the time. Demonstration, Case Given (10) written scenarios, you will execute each GUR Refund in IDX. Posting INS refunds By the end of this lesson you will be able to enter a INS Refund 80% of the time. Demonstration, Case Given (10) written scenarios, you will execute each INS Refund in IDX. Posting CRTs By the end of this lesson you will be able to enter a CRT 80% of the time. Demonstration, Case Given (10) written scenarios, you will execute each INS Refund in IDX. Posting CRTs By the end of this lesson you will be able to enter a CRT 80% of the time. Demonstration, Case Given (10) written scenarios, you will execute each INS Refund in IDX. TOTAL 4.00

11 Lesson Tasks Learning Objective Training Method Posting Payments Posting EDI Payments At the conclusion of this Classroom, lesson, you will be able to Simulation post payments via the EDI. Assessment Time Provided (5) scenarios, post each payment in IDX. 1 TOTAL