UHP · 10/1/2020 · 91 1234 ALA MOANA ST. 808 -841 1234 (H) 808-888-1234 (M) 123-45-6789. Click...
Transcript of UHP · 10/1/2020 · 91 1234 ALA MOANA ST. 808 -841 1234 (H) 808-888-1234 (M) 123-45-6789. Click...
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UHPREGISTRATION MANUAL
(HPH EPIC)Revised September 2020
**ALL INFORMATION PROVIDED ON THIS MANUAL IS SUBJECT TO UPDATE WITHOUT NOTICE. YOU WILL BE EMAILED A REVISED MANUAL WHEN CHANGES ARE MADE**
For any Registration & Insurance questions please contact:ERIN – [email protected] or Ph# 469-4936
LESA – [email protected] or Ph# 469-4918 (Insurance Access Administrator)
All other billing questions: [email protected] or Ph# 469-49001
mailto:[email protected]
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If Reg button not on tool bar: Click the “EPIC icon”, click “Registration/ADT”, & click “Registration”
This pop-up will appear if “A matching patient was not found” – Ok, to select
“New” to create “New Patient”
REGISTRATION PATIENT LOOKUP/SEARCH AND SELECT BOX1. Search/LookUp by entering patient’s FULL “Last name” (comma), “First name”. Enter patient’s “Sex”, “SSN” (if provided), & “DOB” (red highlighted fields) to filter the system for a closer match. **EXHAUST ALL EFFORTS TO FIND YOUR PATIENT TO AVOID DUPLICATE ACCOUNT**
2. IF YOUR PATIENT IS ALREADY REGISTERED IN EPIC - PROCEED TO STEP 6 ‘ENCOUNTER SELECTION BOX” (NEXT SLIDE).2
This pop-up will appear if the patient is in epic or another
patient is a close match to the search criteria.
**VERIFY ALL VALID IDENTIFIERS THAT ALL
DESCRIPTORS MATCH WITH THE PATIENT YOU ARE ENTERING,
BEFORE “SELECTING” **(To avoid DUPLICATE
PATIENTS)**
TEST,ALOHA - 31234567
01/01/1980
91 1234 ALA MOANA ST
808-841-1234 (H)808-888-1234 (M)
123-45-6789
Click the wrench icon to customize your toolbar
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NEW PATIENT 3. “Name Edit” box will populate the appropriate fields from the Patient Lookup box.
4. Please be sure to complete Patient’s “Middle name” and the additional fields if provided.
5. Preferred name/Preferred Type: PSUEDONYM – a name patient wants to go by; stage name.
**USE ALL CAPS WHEN ENTERING REGISTRATION INFORMATION**
ENCOUNTER SELECTION BOX**This pop-up box will appear soon after patient search for ‘Patient’s already in EPIC”**
6. In this box you are able to view all encounters that have been created for a patient in EPIC. A new encounter is created for every appointment. A Registration encounter is automatically created when a patient is created in EPIC (select this encounter)
Or Select appropriate encounter (most recent) that needs to be updated (Reg, Appointment, and PCP) **Appt Encounter: visits & registration linked or pertaining to a specific appt or admission. Selecting will allow you to link a claim record to appt & modify account/coverage into specific visit.**
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TEST,ALOHA
A TALOHA TEST
01/01/1980888-1234
31234567
BRAUER,STEVEN
TEST,ALOHA
TEST,ALOHA
TEST,ALOHA
P/F TEST,ALOHA [2160000000]
01/01/1980 (40 yrs) MRN: 31234567
STE 123491 1234 ALAMOANA STHONOLULU, HI 96813 808-888-1234
BRAUER, STEVEN MD
TEST,JOHN (SPOUSE)808-999-1234
INTERACTIVE FACE SHEET – REGISTRATION/PATIENT’S NAME FOLDER Patient’s Registration Account – this screen is called the “Interactive Face Sheet”. This “Face Sheet” is a summary of 3 Registration folders: Patient’s Name Folder/Interactive Face Sheet (Demographics, PCP/Employer, Patient Contacts, Visit Info, & Additional Info) tabs, Guarantor Accounts Folder (Guarantor Account Types Folder & Cvg & Add’l Info) tabs, and Coverages Folder (Coverage Name Folder & Coverage Info) tabs.
**PATIENT’S STORYBOARD (LEFT SECTION) WILL BE YOUR HEADER THROUGOUT THE PATIENT’S EPIC ACCOUNT**Tip: Click each Registration Folders and Tabs (from top to bottom) or click “Blue Hyperlink Next” (bottom of Interactive Face Sheet). **So no steps/tabs are missed**
THE “INTERACTIVE FACE SHEET” WILL BE COMPLETED AFTER YOU COMPLETE ALL REGISTRATION FOLDERS/TABS (SLIDE 33).
Registration Folders includes: Patient’s Name
Folder, Guarantor Accounts Folder, and Coverages
Folder.
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THIS IS WHERE YOU SCAN IN THE PATIENT’S ID, TCS, REFERRALS/AUTHORIZATIONS, ETC**PLEASE SEE ADDITONAL SCANNING INFO ON SLIDE 29**
THIS LEFT SECTION IS CALLED YOUR
STORYBOARD – allows you to review your
Patient’s Information quickly by hovering over
the diff sections.
You can customize this section by clicking on the wrench icon (upper right
on screen).
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808-841-1234
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DEMOGRAPHICS TAB – Registration/Patient’s Name Folder7. Enter all demographics provided for the patient (Address & Ph# REQUIRED). Yellow triangle fields are not required but highly recommended. **Information collected is very important because it impacts the patient’s medical care, guarantor’s account information, & insurance billing**
8. Address – If address can’t fit on one line, please enter as shown above (2 lines max). **Enter “zip code” in the “City” field to auto-populate the correct city, state, county, & zip code in it’s field**
TEST,ALOHA
40 01/01/1980-888-123431234567
BRAUER,STEVEN
ALOHA TEST
A T
TEST,ALOHA
TEST,ALOHA
ALOHA TEST
01/01/1980
STE 123491 1234 ALAMOANA ST
(96813) HONOLULU
96813
123-45-6789
NOTEST,ALOHA
808-841-1234
808-888-1234
No Religious Preference
DO NOT ENTER ANY INFORMATION IN THIS FIELD
Click “magnify glass” for SSN default 999-99-9999If no SSN provided
List all names Patient may go by or Patient’s Maiden Name
“Pencil” icon – will access Patient Contact Window. You can “ADD, VIEW, & EDIT”
addt’l info about the Patient’s Contact #’s (i.e. days of the week to call, start & end time, phone priorities, & addt’l notes).
**Primary Phone# will be BOLDED on the “Interactive Face Sheet”
Enter info necessary for Patient’s Registration
TIP: Enter “zip code” in the “City” field to auto-
populate the correct city, state, county, & zip code
in it’s field.Fields with:Magnifying glass – opens a drop-down list of selectionsYellow Yield Signs – not required fields but recommended Red Yield Signs – required fields & must be completed
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TEST, ALOHA
BRAUER,STEVEN MD 808-469-1234
“PCP INFO” Box – Click Add/Edit blue hyperlink to assign a PCP.
Click Employer “magnify glass” for a drop down list of Employers. Select the correct Employer.
Or type “NOT ON FILE” in the Employer field to free text an Employer not loaded into EPIC.
EPIC will auto default this field.
Click PCP “magnify glass” for a dropdown list of Providers. Select
correct PCP.
PCP / EMPLOYER TAB – Registration/Patient’s Name Folder
9. PCP INFO Box – Add/Edit PCP by clicking the blue hyperlink. Enter PCP Fields: PCP, PCP Type (General/Specialty), and start date. Only enter an end date when provided/editing. **Assigning a PCP allows EPIC to track a Patient’s association with a specific Provider**
10. EMPLOYER – Enter Employer Information (Employer, Address, Employment Status, Occupation, Ph#) if provided (not required but recommended). Most companies are loaded into EPIC, if Employer not listed type “NOT ON FILE” in the Employer field & follow step shown above. 6
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TEST,ALOHA
TEST,ALOHA
TEST,JOHN
SPOUSE 808-999-1234
TEST,JOHN 808-999-1234SPOUSE
Patient Contact Toolbar:Inactivate – you can activate
Patient contact if needed.Move Up/Move Down –
prioritizing patient contact listPencil icon (Edit) –Add/Edit/Delete
Expand Pt Contact Info –expand saved patient contact
info.
TEST,JOHN
Add Contact blue hyperlink - will open “Add Contact” box to enter limited Patient Contact Information: Name, Relationship, & Primary phone (please select Home, Work, or Mobile. **All other fields can be entered if provided**
Pencil icon (in Patient Contact Toolbar) – will expand the “Patient Contact Information” to a more detailed information box that you can Add/Edit/Delete additional info (if provided). **This is where you can also DELETE the selected Patient Contact**
PATIENT CONTACTS TAB – Registration/Patient’s Name Folder 11. Add Patient Contacts - This is where you will “Add (New/Additional), Edit, Inactivate, Prioritize or Delete” Patient’s Contact Information. Complete Required Fields: Name, Address (Pull Info “if address is the same as patient to populate into appropriate field), Phone number (Primary click Home, Work, Mobile), and Relation to Patient **ALL OTHER FIELDS ARE NOT REQUIRED BUT RECOMMENDED**
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Visit Filing Order (VFO)– will be grayed out if you are doing straight Registration and not going through Appt Scheduling.
NOT A REQUIRED FIELD
VFO (through Visit Appt Scheduling) –This is where to link the coverage to the visit/appointment after you complete all
Registration Folders/Tabs (Coverages added).
VISIT INFO TAB – VISIT FILING ORDER (VFO)VISIT FILING ORDER (VFO) – The ability to individually designate the filing order of coverages for visits/encounters. You can add an unused coverage, remove coverage(s), and adjust the filing order by using the up and down arrows. **The “Visit Account and Filing Order” button will be grayed out when accessed through Registration and not through Scheduling**
PLEASE SEE ADDITIONAL SLIDE 57 FOR MORE ON VISIT FILING ORDER (VFO)
Guarantor Account – make sure the appropriate Guarantor Account is selected (PF, CONF, WC, No Fault)
Visit Coverages (Overridden) / Unused Coverages –A) Click on the “+” in the Unused Coverages section if coverage should be linked to the encounter.B) Click on “X” to not use coverage(s) for this encounter (remember to remove coverages such as
VA or VA Triwest if they should not be billed for this visit).C) Click on “Use Default Coverages” if all coverages should be linked.
D) Click in “Do not bill insurance” box if no insurance to be billed (SELF PAY)E) Click the up & down arrow to adjust the filing order.
LLAGMAY
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RESEARCH TAB – Registration screen
WE DO NOT USE THIS TAB. Click Next.TEST,ALOHA
TEST,ALOHA
TEST,ALOHA
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ADDITIONAL INFO TAB
Additional Patient Information – Not a required section. This section is based on your department/clinic process.
Communication Options – Not a required section. This section is based on your department/clinic process.
Click Next.
WE DO NOT USE THIS TAB/SECTION
Registration screen
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TEST,ALOHA
P/F - TEST,ALOHA TEST,ALOHA
21600123456 – TEST,ALOHA
CLICK ADD GUARANTOR ACCOUNT
Guarantor & Account Type will default to Patient and Personal Family (PF)
Personal/Family (PF) – Most charges (including VA)Confidential (CONF) – Used for OBGYN ITOPs Psych, and Clint Spencer (HIV clinic)No Fault (NF) – Motor Vehicle Accident (MVA)Special Account – Not used by UHPWork Comp (WC) – Work injury
TEST,ALOHA
Guarantor Account Types (folders) will list here
GUARANTOR ACCOUNTS FOLDER (GUARANTOR ACCOUNT TYPES FOLDER)12. Add Guarantor (click Search/New and click Yes to Create a new account)– person who is responsible for paying the bill. A) This is usually self/patient B) Parent/Legal Guardian of minor C) Parent has legal guardianship of an adult child D) An adult child with power of attorney of their elderly parent. **There could be other situations but these are the most common**
Account Type Folders– Coverages listed in these accounts are specific to the Account Type you create (i.e. NF – Motor Vehicle Accident coverages & WC – Employer’s WC Coverage) **Please see additional slides 34-35 on how to Add Guarantor Account Type Folders**
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA
STE 123491 1234 ALAMOANA ST
96813
123-45-6789
F 01/01/1980
808-888-1234
Current Patient – pulls patient’s demographic & employer info.Guarantor – pulls guarantor’s demographic info.Another Patient – pulls demographic info from another patient in the EPIC.
Preview Info – allows you to preview the demographic info you are going to pull.All Info – pulls demographic & employer info.Address Only – pulls address & home phone info.
GUARANTOR ACCOUNT TYPE FOLDER (DEMOGRAPHICS)13. Add Guarantor Account’s Demographics by A) Pulling “All Info” if it’s Self/Patient B) Pull “Address Only” for Other Sources (parent/legal guardian, emancipated minor, & person with Power of Attorney over the patient) C) You can manually enter required fields highlighted in red & if Other Source has different address than patient or patient has a different billing address “Rel to patient” must be completed. **Please be sure to pull “All Info” or “Address Only” for Guarantor Account Types & Coverage Subscriber Info**
Guar Acct Notes – Allows you to view/enter Registration
notes regarding the patient’s account which may be helpful
in researching coverage or billing inquiries.
DEFAULTED OR BLANK (UNLESS REQ)
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA 01/01/1980 123-45-6789 F 808-888-1234 SELF
The Coverage Wizard Query screen will open when Adding a coverage. There are slight cosmetic differences with how
you enter coverages. The Coverage Info Section will depend on the Insurance selected.
COVERAGE & ADDITIONAL INFO TAB (GUARANTOR ACCOUNT TYPE FOLDER) 14. Add Coverage – a Coverage Wizard Query will open up. Type Coverage Name to Search. **The Coverage Wizard Query steps will depend on the Insurance selected if it is EEV (electronically verifiable) or Manual verifiable (Override Query)**
If patient does not have any insurance they are considered “Self Pay”, DO NOT click Add. Patient will receive a statement.
TYPE COVERAGE NAME TO SEARCH
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COVERAGE SELECTION & SUBSCRIBER SELECTION BOX– COVERAGE WIZARD QUERY
15. A “Payer/Plan Select” box will open up please select the correct coverage **Verify Coverage name & address by the coverage card/online**
16. Then a “Subscriber Selection” box will open up for you to select the Subscriber for this Coverage. **If you select the incorrect Subscriber please continue & complete the Coverage Wizard Query or do the “Override Query (Manual Verify step) & when you are at the Patient’s Registration page, click the “Coverage Name ” under the Coverage folder & update the “Member’s Relationship to Subscriber/Relationship to Subscriber” field (instructions on continued pages).”
**SELECT THE CORRECT SUBSRIBER”SELF- Patient/Guarantor
SOMEONE ELSE – Other than Patient
“PLEASE VERIFY THE COVERAGE/PAYOR NAME & ADDRESS ON THE PATIENT’S COVERAGE CARD (FRONT & BACK) OR ONLINE”
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Click “Override Query” to Manually enter a Manually Verified Coverage
TEST,ALOHA
123-45-6789
01/01/1980
STE 123491 1234 ALAMOANA ST
(96813) HONOLULU
96813
OAHU
CLICK “SEND” TO ELECTRONICALLY VERIFY A COVERAGE (PLEASE OVERRIDE QUERY FOR NEW PATIENT REGISTRATION)
SUBSCRIBER OTHER THAN SELF – PATIENT’S INFO WILL AUTO-POPULATE IN THIS SECTION (YOU MUST ONLY ENTER “MEMBER ID” FIELD)
E-verify (Eligibility Query)
OR
Manual Verify (Override Query)
MUST ENTER SUBSCRIBER ID TO E-VERIFY
ELIGIBILITY QUERY – COVERAGE WIZARD QUERY17. Verifying Coverage Eligibility (Select by how you want to verify) :
Manual Verify (Override Query) – coverage plans do not have an E- before the Coverage Name (Commercial Coverages). You will need to enter all information & verify the coverage Manually. **Please use Override Query when entering New Patient Registration** Click “Override Query” & continue to the Coverage screen to enter manually.
E-Verify (Eligibility Query) – coverage plans will have an E- before the Coverage name which will appear when Coverage Wizard Query is complete (All Coverages are listed under the Coverage Folder). **If the coverage is NOT E-verifiable the Coverage Wizard will direct you straight into Override Query to enter Manually** Click “Send” to submit the E-verification Query & continue to next slide.
ENTER SUBSCRIBER INFO WHEN SUBSCRIBER IS OTHER THAN SELF
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA 01/01/1980 123-45-6789 FR000012345678
03/01/2019
TEST,ALOHA01/01/1980
STE 1234, 91 1234 ALAMOANA STHONOLULU
HI
96813
TEST,ALOHA (21600123456)
E-verification Response Notification – E-verification response will show in this box here “A WAITING
RESPONSE or RESPONSE RECEIVED” CLICK RESPONSE WHEN RESPONSE RECEIVED
RESPONSE RECEIVED WILL OPEN UP THE COVERAGE ELIGIBILITY SCREEN WITH THE E-VERIFICATION STATUS (STATUS MAY CHANGE)
RESPONSE HISTORY – E-VERIFICATION DETAILED INFO:
PATIENT TAB – MEMBER ID, EFFECTIVE DATES **REMEMBER EFFEC DATES**, SUBSCRIBER NAME, DOB, & ADDRESS.
DETAILS TAB – DETAILED INFORMATION OF THE PLAN NAME, COVERAGE CODES/NUMBER, PLAND DATE, PAYOR INFORMATION, OTHER
PAYOR/ADDITIONAL INFO **PCP/HEALTHCENTER**, ETC.
E-VERIFICATION RESPONSE NOTIFICATION – COVERAGE WIZARD QUERY 18. “Response Notification” box - A sent E-verification query will take you to back to the “Cvg & Add’l Info” page that will display “A WAITING RESPONSE” in the box. When a response is received a blinking notice will display. Click “RESPONSE RECEIVED” box to view Coverage status (Eligible/E-verified, Could Not Be Processed/E-rejected, and Eligible w/addt’l info).
19. “Coverage Eligibility” box will open up with the E-verification status (status may change see next slide), Patient Information, and Details information **be sure to review all information provided & write down “Effec From” date**. Click “Create Coverage” - if Coverage is “ELIGIBLE” and all information reviewed (continue to slide 17).
A sent E-verification query will bring you back to this page with the E-verify Response Notification box (follow below instructions).
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“E-REJECTED / COULD NOT BE PROCESSED”
A. Review the Response Received/Response Hx “Could Not Be Processed” Admin Info explanation as to why Coverage E-rejected.
B. Click “Ignore Response” – the intended plan will not be created unto the account).
C. You will be directed back to the visit registration to add another Coverage through Override Query or to start over through E-verification Query.
“ELIGIBLE” BUT THE RESPONSE REFLECTS AN UPDATE ON THE ACTIVE COVERAGE
A. Review the Response Received/Response Hx “Highlights” explanation (i.e.: “found active coverage code 828 when 814 was expected or spelling of Patient’s name is slightly different than what the Insurance has on file). Please be sure to print screen or write this info down.
B. Click “Ignore Response” – the intended plan will not be created unto the account.
C. Proceed to Add Coverage w/the active “coverage code” indicated in the “Highlights” explanation through E-verification Query or Override Query.
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TEST,ALOHA
TEST,ALOHA (21600123456)
TEST,ALOHA
1AB2CD3EF45
R000012345678
TEST,ALOHA (21600123456)
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TEST,ALOHA
ALOHA TEST
R000012345678
SELF
01/01/2019
828
COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (HMSA COVERAGE)“E-verify Query” (after you select Create Coverage) and “Override Query” will direct you to this page to complete (E-verify you will only need to enter “Member eff from date”). **COVERAGE NAME FOLDER (THROUGH COVERAGE WIZARD QUERY OR REGISTRATION) SCREEN WILL COSMETICALLY CHANGE PER COVERAGES SELECTED**
20. HMSA COV FOLDER - enter required fields highlighted in red. Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen).**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (but is available on the Patient’s Registration)**
/ COVERAGE WIZARD QUERY - HMSA COVERAGE
“Override Query” – will bring you to manually
enter verified Coverage info through the
Coverage Wizard Query.
“E-verify Query” (after you select Create
Coverage) – will bring you to the Coverage
Name Folder in Registration.
E - HMSA
ENTER IF COVERAGE TERMED OR BREAK IN COVERAGE
ENTER FOR HMSA PLANS
MEDICARE COVERAGE ONLY
Click “Verify Cvg” – to E-verify active coverages already on file.
**”MEMBER VERICATION STATUS” box will auto-populate for coverages that are
E-verifiable (E-verified or E-rejected)**
Click the “Mem verif status” magnify glass - for non E-verifiable coverages or
coverages entered through the Override Query to MANUALLY select (Verified,
Rejected, Needs Review, Pending PSR).
WORKS ONLY IF SUBSCRIBER IS SELF HMO/QUEST PLANS ONLY
ENTER THESE FIELDS ONLY IF PATIENT HAS MEDICARE AS OTHER COVERAGE
(FOLLOW MSPQ)
ALT Patient’s Name will be billed to Insurance(Name not updated w/Insurance )
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MEDICARE A&B
“Override Query” – will bring you to manually
enter verified Coverage info through the
Coverage Wizard Query.
“E-verify Query” (after you select Create
Coverage) – will bring you to the Coverage
Name Folder in Registration.
ALOHA TEST
1AB2CD3EF45
123-45-6789
/ COVERAGE WIZARD QUERY - TRADITIONAL MEDICARE COVERAGE
Replace existing HIC # with the new MBI # in the Subscriber ID field (MBI # - 12 AlphaNumeric NO DASHES)
Enter existing HIC # (SSN #) in the MBI # field
COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (TRADITIONAL MEDICARE) TRADITIONAL MEDICARE FOLDER - enter required fields highlighted in red. Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen). For Traditional Medicare Coverage, replace the existing HIC # with the new MBI # in the “Subscriber ID” field under this coverage **Do not create a New Medicare Plan**
**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (but is available on the Patient’s Registration)**
ENTER IF COVERAGE TERMED OR BREAK IN COVERAGE
MEDICARE COVERAGE ONLYWORKS ONLY IF SUBSCRIBER IS SELF
1AB2CD3EF45
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HMSA AKAMAI
12345678
12345678
ALOHA TEST
1AB2CD3EF45
WORKS ONLY IF SUBSCRIBER IS SELF MEDICARE COVERAGE ONLY
ENTER IF COVERAGE TERMED OR BREAK IN COVERAGE
“Override Query” – will bring you to manually
enter verified Coverage info through the
Coverage Wizard Query.
“E-verify Query” (after you select Create
Coverage) – will bring you to the Coverage
Name Folder in Registration.
/ COVERAGE WIZARD QUERY - MEDICARE ADVANTAGE PLANS
Enter the new MBI # in the “MBI #” field(MBI # 12 AlphaNumeric NO DASHES)
COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (MEDICARE ADVANTAGE PLANS)MEDICARE ADVANTAGE PLANS FOLDER- enter required fields highlighted in red. Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen). For Medicare Advantage Plans, enter the new MBI # in the field labeled MBI # (as shown above).
**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (but is available on the Patient’s Registration)**
HMSA HMO/PPO AND UHC MEDICARE/MEDICAID PLAN ONLY
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“Override Query” – will bring you to manually
enter verified Coverage info through the
Coverage Wizard Query.
“E-verify Query” (after you select Create Coverage) –
will bring you to the Coverage Name Folder in
Registration.
HMSA HMO/PPO AND UHC MEDICARE/MEDICAID PLAN ONLY
WORKS ONLY IF SUBSCRIBER IS SELF
TEST,ALOHA 0000123456
LAGMAY,LESA (21LL1)
0000123456
HMO/QUEST PLANS ONLY
ENTER MEDICAID/QST ISSUED # IF DIFFERENT FROM SUB ID#
Click Patient’s name blue hyperlink to enter REQUIRED field “Member relationship to subscriber” and “Effective from” date.
0000123456
TEST,ALOHA
ENTER ONLY IF THERE’S A BREAK IN COVERAGE
“Coverage Member Info” box –is the only section that will
provide all active/termed/break in coverage for QST..
The “Coverages” folder on the Reg screen will only show the
current QST coverage.
/ COVERAGE WIZARD QUERY - QUEST INTEGRATION ABD/NON ABD
COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (QUEST INTEGRATION ABD/NON ABD)QUEST INTEGRATION ABD/NON ABD FOLDER - enter required fields highlighted in red. Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen). The “Coverage Member Information” box is the only step different from other Coverages. **Even if QST INT eligibility are month to month we would only enter a term date if there is a “break in coverage” within the month (E-verification lasts 30 days till next verification required)**
Patient’s can fall under 2 different QST plans ABD (age, blind, & disabled) or NON ABD (patient’s qualify based on income and not ABD). A patient may qualify for Medicare & Medicaid (Medi/Medi) dual coverage through UHC COMM dual plan. Please select QST INT plans accordingly to what is on the insurance card or online.
**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (but is available on the Patient’s Registration)** 20
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“Override Query” – enter manually through Coverage
Wizard.
“E-verify Query” – will auto-populate info & bring you to Coverage Name Folder in Registration.
111123456
111123456
1AB2CD3EF45
ENTER IF COVERAGE TERMED OR BREAK IN COVERAGE
WORKS ONLY IF SUBSCRIBER IS SELF MEDICARE COVERAGE ONLY
Enter the new MBI # in the “MBI #” field(MBI # 12 AlphaNumeric NO DASHES)
MUST - ENTER “HIDSNP” FOR UHC MEDICARE ONLY
UHC COMM PLAN
/ COVERAGE WIZARD QUERY - UHC MEDICARE DUAL (MEDI/MEDI)
COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (UHC COMM MEDICARE DUAL (MEDI/MEDI)UHC COMM PLAN MEDICARE DUAL COMPLETE (MEDI/MEDI) FOLDER - enter required fields highlighted in red. Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen).Patient has Dual Coverage - UHC Comm Medicare Dual and QST Int UHC Comm Medicaid/Quest (Medi/Medi) **SEE NEXT SLIDE FOR DUAL COVERAGE INFO**
**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (but is available on the Patient’s Registration)**
UHC DUAL COVERAGE – MEDI/MEDI
ALOHA TEST
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“Override Query” – enter manually through Coverage
Wizard.
“E-verify Query” – will auto-populate info & bring you to Coverage Name
Folder in Registration.
TEST,ALOHA 01/01/2020 0000123456
0000123456
E – QST INT UHC COMM
UHC DUAL COVERAGE – MEDI/MEDI
/ COVERAGE WIZARD QUERY - QST INT UHC COMM MEDICAID (MEDI/MEDI)
MUST - ENTER “HIQI” FOR UHC MEDICAID/QST ONLY
WORKS ONLY IF SUBSCRIBER IS SELF
HMO/QUEST PLANS ONLY
Click Patient’s name blue hyperlink to enter REQUIRED field “Member relationship to subscriber” and “Effective from” date.
COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (QST INT UHC COMM MEDICAID (MEDI/MEDI)QUEST INTEGRATION UHC COMM MEDICAID (MEDI/MEDI) FOLDER - enter required fields highlighted in red. Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen). The “Coverage Member Information” box is the only step different from other Coverages. **Even if QST INT eligibility are month to month we would only enter a term date if there is a “break in coverage” within the month (E-verification lasts 30 days till next verification required)**Patient has Dual Coverage - UHC Comm Medicare Dual and QST Int UHC Comm Medicaid/Quest (Medi/Medi) **SEE PREVIOUS SLIDE FOR DUAL COVERAGE INFO**
**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (but is available on the Patient’s Registration)**
HMSA HMO/PPO AND UHC MEDICARE/MEDICAID PLAN ONLY
TEST,ALOHA
0000123456
ENTER ONLY IF THERE’S A BREAK IN COVERAGE
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ALOHA TEST123456789- 01
123456789- 02SPOUSE
ENTER THESE FIELDS ONLY IF PATIENT HAS MEDICARE AS
OTHER COVERAGE (FOLLOW MSPQ)
TEST,ALOHA (21LL1)
“Override Query” – will bring you to manually enter verified
Coverage info through the Coverage Wizard Query.
“E-verify Query” (after you select Create Coverage) –
will bring you to the Coverage Name Folder in
Registration.
E – UHA 3000
WORKS ONLY IF SUBSCRIBER IS SELF HMO/QUEST PLANS ONLY
MEDICARE COVERAGE ONLY
UHA ONLY – SUBSRIBER ID# FIELD ENTER 9 DIGIT HYPHEN 2 DIGIT PRIMARY COV HOLDER CODE
123456789-01
INSURANCE ID# FIELD – ENTER PATIENT’S 9 DIGIT HYPHEN 2 DIGIT DEPENDENT CODE ( 01-PRIMARY
COVERAGE HOLDER, 02-SPOUSE, 03-CHILD, 04-OTHER DEPENDENTS).
COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (UHA COVERAGE)“E-verify Query” (after you select Create Coverage) and “Override Query” will direct you to this page to complete (E-verify you will only need to enter “Member eff from date”). **COVERAGE NAME FOLDER (THROUGH COVERAGE WIZARD QUERY OR REGISTRATION) SCREEN WILL COSMETICALLY CHANGE PER COVERAGES SELECTED**UHA COVERAGE FOLDER - enter required fields highlighted in red. UHA ONLY - Enter Subscriber ID# and Insurance ID# with the appropriate 2 digit dependent code (as shown above). Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen).
**The Subscriber Info Tab is now available in the Coverage Wizard Query when the Subscriber is Other Than Self (see slide 25)**
ENTER IF COVERAGE TERMED
/ COVERAGE WIZARD QUERY - UHA COVERAGE
HMSA HMO/PPO AND UHC MEDICARE/MEDICAID PLAN ONLY
When the Subscriber is OTHER THAN SELF – Please complete the “Subscriber Info” tab (make sure you get the Sex & DOB of Subscriber)
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COVERAGE NAME TAB – Coverage Wizard Query or Registration (HEALTHNET TRICARE PLANS) HEALTHNET TRICARE PLANS FOLDER - enter required fields highlighted in red. Enter Patient’s “Benefit #” (located on the back of Patient’s Military ID) or Subscriber’s/Sponsor’s SSN# in the Subscriber ID field **Any other ID# entered into this field will hit a Claim Edit WQ** . Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen).
Subscriber is OTHER THAN SELF/SPOUSE – Please complete the “Subscriber Info” tab (make sure you get the Sex & DOB of Subscriber/Other than self) **The Subscriber Info Tab is now available in the Coverage Wizard Query when the Subscriber is Other Than Self (see Subscriber Info Tab slide 26)**
TEST,ALOHA01234567801
SPOUSE
TEST,ALOHA
/ COVERAGE WIZARD QUERY - HEALTH NET FED SVC – TRICARE SELECT (TRICARE)
“Override Query” – will bring you to manually enter verified Coverage info through the Coverage
Wizard Query.
“E-verify Query” (after you select Create Coverage) –
will bring you to the Coverage Name Folder in
Registration.
HEALTH NET-TRICARE
ENTER IF COVERAGE TERMED
HMSA HMO/PPO AND UHC MEDI/MEDII PLAN ONLY
MEDICARE COVERAGE ONLY
WORKS ONLY IF SUBSCRIBER IS SELF HMO/QUEST PLANS ONLY
ENTER THESE FIELDS ONLY IF PATIENT HAS MEDICARE AS
OTHER COVERAGE (FOLLOW MSPQ)
ENTER Patient’s “BENEFIT’S #”located on the back of the
Patient’s Military ID (MIL ID) OR Subscriber/SPONSER’S “SSN#” in
the “Subscriber ID” field.**ANY OTHER ID# ENTERED INTO THIS FIELD WILL HIT A CLAIM EDIT
WQ**
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/ COVERAGE WIZARD QUERY - TRIWEST HEALTH ALLIANCE / VA CCN
MEDICARE
SUBSCRIBER SSN#
SELF
03/22/2020 03/22/2021
ENTER THE AUTHORIZED DATE RANGE ON THE VA/TRIWEST HEALTHCARE ALLIANCE AUTH RECEIVED FOR APPROVED SERVICES
WORKS ONLY IF SUBSCRIBER IS SELF
NOT REQUIRED
SELECT MANUALLY VERIFIED IF AUTHORIZATION RECEIVED
MEDICARE COVERAGE ONLY
TEST,ALOHA
TEST,ALOHA
TEST,ALOHA
21600123456-TEST,ALOHA
MEDICARE MEDICARE A&B X
X
MOVE COVERAGE UP ONE POSITION
REMOVE MEDICARE COVERAGE
You will need to use the VFO in the “Visit Info” tab under the Patient’s
name Folder & click the “Visit Account and Filing Order” button.
**It is very important to remove other coverages when an approved VA auth is on file & will be billed for
this visit/encounter**
Follow the steps below
COVERAGE NAME TAB – Coverage Wizard Override Query (VA CCN -TRIWEST HEALTHCARE ALLIANCE)VA CCN – TRIWEST HEALTH ALLIANCE (UNDER P/F ACCOUNT) – Veterans who are entitled to Medicare may choose which program will be responsible for payment covered by both programs. However, if services were “Authorized” by VA at the present time we are ONLY allowed to bill VA **Please see above VFO instructed steps**
VA CCN (TRIWEST HEALTH ALLIANCE) - enter required fields highlighted in red. Enter Patient’s SSN# in the Subscriber ID field **Any other ID# entered into this field will be denied by VA CCN (TRIWEST HEALTH ALLIANCE) DO NOT ENTER AUTH# IN THIS FIELD**. Member Effective From & Effective To dates will need to be entered with the VA Authorized Date Range for the approved services. Follow the above instructions on how to enter specified fields (see other Coverage Name Folder screen).
ANY OTHER ID# WILL GET DENIED
BY PAYOR (PLS DO NOT
ENTER AUTH # IN THIS FIELD)
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Override Query– The “Subscriber Info” tab will not be available in the Coverage Wizard Query if Subscriber is
SELF.
“Subscriber Info” can be accessed on the Patient’s Registration screen under it’s Coverage Name Folder.
/ COVERAGE WIZARD QUERY
SUBSCRIBER’S NAME
STE 123491 1234 ALAMOANA ST
(96813) HONOLULU
96813
OAHU
R000012345678
F 01/01/1980
808-888-1234
UHP OF HAWAII
STE 1001677 ALA MOANA BLVD
(96813) HONOLULU
SUBSCRIBER INFO TAB – Coverage Wizard Query (if Subscriber is other than Self) or Registration21. SUBSCRIBER INFO TAB – enter in required fields highlighted in red (all other fields are not required, but recommended). You can click the “Pull Info” icon to pull in specific information (see above instructions).
***THE SUBSCRIBER INFO TAB WILL NOT BE AVAILABLE IN THE COVERAGE WIZARD QUERY IF SUBSRIBER IS SELF (INFO WILL AUTO-POPULATE FROM THE PATIENT’S DEMOGRAPHICS TAB). SUBSCRIBER INFO TAB CAN BE ACCESSED ON THE PATIENT’S REGISTRATION SCREEN UNDER IT’S COVERAGE NAME FOLDER**
Current Patient – pulls patient’s demographic & employer info.Guarantor – pulls guarantor’s demographic info.Another Patient – pulls demographic info from another patient in the EPIC.
Preview Info – allows you to preview the demographic info you are going to pull.All Info – pulls demographic & employer info (for Self/Patient).Address Only – pulls address & home phone info (for Other Sources/Other than Self – if diff address than pt **rel to guarantor field must be completed**
**Please be sure to pull “All Info” or “Address Only” for Guarantor Account Types & Subscriber Info**
**SUBSCRIBER NAME, ADDRESS, SEX & BIRTH DATE IS A REQUIRED FIELD**
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Coverage Wizard Query –from the Override Query
will bring you to complete the Coverage Selection Info.
“Claim Address” can be accessed on the Patient’s Registration screen under it’s Coverage Name Folder.
BILLING ADDRESS FOR PROFESSIONAL CHARGESIF FIELDS IN THIS SECTION ARE NOT GRAYED OUT YOU WILL NEED TO ENTER THE
COVERAGE ADDRESS MANUALLY. FIELDS WILL NOT BE GRAYED OUT FOR COVERAGES NOT LOADED INTO EPIC (IE: UHC PLANS, CIGNA, AETNA, & ANY COMMERCIAL PLANS)
BILLING ADDRESS FOR HOSPITAL CHARGES.**UHP DOES NOT DO HOSPITAL CHARGES**
CLAIM ADDRESS TAB – Coverage Wizard Query or Registration (Coverage Name Folder)CLAIM ADDRESS TAB - displays the Coverage Address in which Claims are to be sent. Most Coverage Address are loaded into EPIC so you won’t need to do anything on this page.
22. Coverages NOT loaded in EPIC – Fields in the “Coverage Address” section will not be grayed out & will be open for you to enter the Coverage Address Manually. Coverages Not loaded: UHC plans, CIGNA, Aetna, & Any Other Commercial plans. Address can be found on the back of the Coverage card or Coverage website.
/ COVERAGE WIZARD QUERY
27
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LAST TAB IN THE COVERAGE WIZARD QUERY –from the Override Query will bring you to complete
the Coverage Selection Info.
“Additional Info” can be accessed on the Patient’s Registration screen under it’s Coverage Name Folder.
Type - Select Insurance Card / Insurance
Verification Eligibility
Document Description –Coverage (HMSA 643, HHIN
Elig screen, HMO XT, etc.
(EPIC WILL AUTO-POPULATE THESE FIELDS)
1. Click on “Scan” button to open up “Image Scanner” screen. Select “Scan Type” as “ADF
Duplex”. Click “Scan”2. On the “Scan/Append Document” screen the
user will have the ability to view all scanned copies before saving images. **Be sure to view
pages 1,2,etc if needed**3. Select “Save Image” if scanned document is legible/accurate. Close to return to the “scan
documents” screen & click “Accept”.
** THIS TRAINING WILL BE DONE AT YOUR DESIGNATED CLINIC/DEPT **
NOT A REQUIRED SECTION (GRAYED OUT)
This field is only used when MSPQ is not provided when
Medicare is “Secondary”.
All other fields are NOT REQUIRED to be entered again. These fields are on the “Coverage Tab”
ADDITIONAL INFO TAB – Coverage Wizard Query or Registration (COVERAGE SCAN)ADDITIONAL INFO TAB – No fields are required as they are already entered on the “Coverage Tab” section. Rev Cycle Use Only field – is ONLY used when MSPQ is not provided when Medicare is “Secondary”. 23. COVERAGE SCAN – THIS IS WHERE YOU WILL SCAN IN BOTH SIDES OF INSURANCE CARDS/ELIGIBILITY VERIFICATION PRINTOUT (SEE STEPS SHOWN ABOVE).
**Coverage Wizard Query - THIS TAB WILL COMPLETE THE COVERAGE WIZARD QUERY & BRING YOU BACK TO THE CVG & ADD’L INFO TAB**
/ COVERAGE WIZARD QUERY
28
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TEST,ALOHA R000012345678
TEST,JOHN 01234567890TEST,ALOHA R000012345678
TEST,ALOHA
TEST,ALOHA
TEST,ALOHA 01/01/1980 123-45-2156
ADD NEW OR ADD’L COVERAGE EDIT/UPDATE ACTIVE/INACTIVE
COVERAGES ON FILE
DELETE FUNCTION WORKS ONLY AFTER YOU
COMPLETE THE “COVERAGE WIZARD QUERY” (IT WILL BE GRAYED AFTER YOU LEAVE
THIS SCREEN)
CVG & ADD’L INFO TAB – Registration (Guarantor Account Type Folder) When you complete the “Coverage Wizard Query” it will direct you back to the “Cvg & Add’l Info” tab in Registration under the Guarantor Account Type Folder. The “Cvg & Add’l Info” tab will list All Coverages entered in the “Coverage Summary” box (shown above).
**THE DELETE FUNCTION WORKS ONLY AFTER YOU COMPLETE THE “COVERAGE WIZARD QUERY” & IS DIRECTED BACK ON THIS PAGE**
WHEN YOU COMPLETE THE COVERAGE WIZARD QUERY IT WILL BRING YOU BACK TO THIS PAGE (CVG & ADD’L INFO TAB)
NOT A REQUIRED TAB (SKIP)
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA
TEST,ALOHA (21600123456)
TEST,JOHN991234567
R000012345678
0000123456TEST,JOHN R000012345678
FILING ORDER – change the numbers to assign filing order (the order which claims gets sent to insurance).
Coverages Folder – lists all active and inactive (grayed out) Coverages for the patient.
Make sure “Show All Coverages” is always defaulted
Click on Coverage Info Tabs listed below the Coverage Name Folder to view/edit Coverage information.
**REVIEW “RESPONSE HISTORY” section each time you E-verify, no matter what the verification status has defaulted to. Response Hx will provide a detailed response & in most circumstances you will be able to make the
required changes to the Coverage(s)**
COVERAGES FOLDER / COVERAGE NAME FOLDERS– Registration (FILLING ORDER)The Coverages Folder – will list all the Coverages entered (active/inactive) for patient and where you will need to make any changes to the Filing Order if needed. **You will need to leave this page & return to show the change/update you made**
Coverage Name Folders – Click on the Coverage Info Tabs (Subscriber Info, Claim Address, Additional Info, **Response History**) listed below it’s Coverage Name Folder to view/edit Coverage Information.
CLICK COVERAGES FOLDER
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A T
TEST,ALOHA
TEST,ALOHA
REGISTRATION SCREEN – INTERACTIVE FACE SHEET (CLICK PATIENT’S NAME FOLDER)PATIENT’S NAME FOLDER/INTERACTIVE FACE SHEET – Click Patient’s Name Folder to view all the data you’ve entered into EPIC by clicking on the Registration tabs/folders . Please review & make the necessary changes & make sure all required fields are entered correctly or you will receive an EPIC warning when trying to leave a Registration account (see slide 31 for additional information).
CLICK PATIENT’S NAME FOLDER TO ACCESS THE INTERACTIVE FACE SHEET
THIS IS WHERE YOU SCAN IN THE PATIENT’S ID, TCS, REFERRALS/AUTHORIZATIONS, ETC (SEE NEXT SLIDE)
CLICK ON ANY FOLDER/TAB TO VIEW/EDIT ANY INFORMATION
CLICK ON ANY HYPERLINK TO VIEW/EDIT THE SELECTED LINK INFO
CLICK ON ANY DOWN ARROWS TO EXPAND SELECTED FIELDS
31
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CLICK PENCIL - THIS IS WHERE YOU SCAN/VIEW/EDIT THE PATIENT’S ID, TCS, REFERRALS/AUTHORIZATIONS, ETC
1. Click on “Scan” button to open up “Image Scanner” screen. Select “Scan Type” as “ADF
Duplex”. Click “Scan”2. On the “Scan/Append Document” screen the
user will have the ability to view all scanned copies before saving images. **Be sure to view
pages 1,2,etc if needed**3. Select “Save Image” if scanned document is legible/accurate. Close to return to the “scan
documents” screen & click “Accept”.
** THIS TRAINING WILL BE DONE AT YOUR DESIGNATED CLINIC/DEPT **
Document Type – click Add to Select/Scan Advance Beneficiary Notice (ABN)
Auth Visit Specific InsuranceGuardianship (Power of Attorney)
Patient IDReferral
Self Pay AcknowledgementTerms and Conditions of Services (TCS) – UCERA
RECEIVED/NOT RECEIVED
EXAMPLE: HAWAII DRIVERS LICENCE (HDL) EXP 12/31/2021
LLAGMAY 09/02/2020
DOCUMENT –DATES EFFEC ON / EXPIRES ON
INTERACTIVE FACESHEET – Registration
24. DOCUMENT SCANNING (ABN, Auth, Referral, Guardianship, Patient ID, Self Pay Acknowledgement, & TCS – UCERA) – This is where you will scan any documents pertaining to Patient’s Registration/Billing.**DOCUMENTS SCANNED IN REGISTRATION WILL AUTOMATICALLY SCAN IN PATIENT’S CHART/MEDIA**
Terms and Conditions of Services (TCS) – Must be obtained: 1) Annually 2) On New Patient 3) Guarantor turns 18 yrs of age 4) Life status change/name change.
(DOCUMENT SCANNING)
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TEST,ALOHA
TEST,ALOHA
REGISTRATION SCREEN – INTERACTIVE FACE SHEET (PATIENT’S NAME FOLDER)REGISTRATION WARNINGS– Please review & make the necessary changes & make sure all required fields are entered correctly or you will receive an EPIC warning when trying to leave a Registration account (shown above). Please be sure to clear/fix all warnings before exiting or the account will fall into a Claim Edit Workqueue (claims that fall into this workqueue does NOT go out to the Insurance). CLINICS/DEPTS ARE RESPONSIBLE TO WORK THEIR REGISTRATION CLAIM EDIT WQs
**REVIEW THE FOLLOWING WARNINGS AS THEY WILL TELL YOU WHAT ACTIONS TO TAKE IN ORDER TO PROCEED**
CLICK PATIENT’S NAME FOLDER TO ACCESS THE INTERACTIVE FACE SHEET
CLICK ON ANY FOLDER/TAB TO VIEW/EDIT ANY INFORMATION
CLICK ON ANY HYPERLINK TO VIEW/EDIT THE SELECTED LINK INFO
CLICK ON ANY DOWN ARROWS TO EXPAND SELECTED FIELDS
33
TEST,ALOHA
-
A T
TEST,ALOHA
TEST,ALOHA
REGISTRATION SCREEN – INTERACTIVE FACE SHEET (PATIENT’S NAME FOLDER)PATIENT’S NAME FOLDER / INTERACTIVE FACESHEET – THIS SCREEN SHOWS A COMPLETE REGISTRATION WITH DATA YOU’VE ENTERED.
IF NO REGISTRATION WARNINGS POP UP WHEN EXITING, YOUR REGISTRATION IS COMPLETE.
**REGISTRATION COMPLETE**
CLICK PATIENT’S NAME FOLDER TO ACCESS THE INTERACTIVE FACE SHEET
CLICK ON ANY FOLDER/TAB TO VIEW/EDIT ANY INFORMATION
CLICK ON ANY HYPERLINK TO VIEW/EDIT THE SELECTED LINK INFO
CLICK ON ANY DOWN ARROWS TO EXPAND SELECTED FIELDS
34
CLICK PENCIL - THIS IS WHERE YOU SCAN/VIEW/EDIT THE PATIENT’S ID, TCS, REFERRALS/AUTHORIZATIONS, ETC
-
HOW TO ENTER OTHER GUARANTOR ACCOUNT TYPES
35
-
CONFIDENTIAL (CONF) GUARANTOR ACCOUNT TYPE
CONFIDENTIAL ACCOUNTS - USED FOR OBGYN ITOPS (TO BILL MEDICAID),
PSYCHOLOGIST AND PSYCHIATRY CASES, & CLINT SPENCER (HIV CLINIC) CASES
36
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GUARANTOR ACCOUNT TYPE FOLDER / SELECTION – CONFIDENTIAL (CONF)1. CONFIDENTIAL ACCOUNT TYPE FOLDER (USED FOR OBGYN ITOPS, PSYCHOLOGIST AND PSYCHIATRY CASES & CLINT SPENCER [HIV CLINIC] CASES) – Click
“Guarantor Accounts Folder” to “Add Guarantor Account” to Patient’s Registration (follow the steps shown above to create the CONF Account Type Folder).
**NOTE: Certain Insurance plans can ONLY be found in CONF Guarantor Accounts. CAMHD, United Behavioral Health, and Ohana Community Care Services (Ohana CCS) are just a few of the Insurance plans that cannot be found in P/F, NF or WC Account Types**
SEE ADDITIONAL SLIDES TO COMPLETE YOUR CONFIDENTIAL GUARANTOR ACCOUNT FOLDER
A T
21600123456 - TEST,ALOHA
CLICK GUARANTOR ACCOUNTS FOLDER ON THE REGISTRATION SCREEN
CLICK MAGNIFY GLASS TO OPEN ACCOUNT TYPE SELECT BOX
TEST,ALOHA
TEST,ALOHA
CONFIDENTIAL - USED FOR OBGYN ITOPS (TO BILL MEDICAID),
PSYCHOLOGIST AND PSYCHIATRY CASES, & CLINT SPENCER (HIV CLINIC) CASES
TEST,ALOHA
**PATIENTS MAY HAVE MULTIPLE CONF ACCOUNTS CREATED ACCORDING TO THE CONF SERVICES RECEIVED**
37
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA
STE 123491 1234 ALAMOANA ST
96813
123-45-6789
F 01/01/1980
808-888-1234
Current Patient – pulls patient’s demographic & employer info.Guarantor – pulls guarantor’s demographic info.Another Patient – pulls demographic info from another patient in the EPIC.
Preview Info – allows you to preview the demographic info you are going to pull.All Info – pulls demographic & employer info.Address Only – pulls address & home phone info.
CONFIDENTIAL GUARANTOR ACCOUNT TYPE FOLDER / DEMOGRAPHICS2. Add Confidential Guarantor Account’s Demographics (Account type field will default to Confidential if this is the selected type) by A) Pulling “All Info” if it’s Self/Patient B) Pull “Address Only” for Other Sources (parent/legal guardian, emancipated minor, & person with Power of Attorney over the patient) C) You can manually enter required fields highlighted in red & if Other Source has different address than patient or patient has a different billing address “Rel to patient” must be completed. **Please be sure to pull “All Info” or “Address Only” for Guarantor Account Types & Coverage Subscriber Info**
Guar Acct Notes – Allows you to view/enter Registration
notes regarding the patient’s account which may be helpful
in researching coverage or billing inquiries.
CONFIDENTIAL
DEFAULTED OR BLANK (UNLESS REQ)
CONFIDENTIAL GUARANTOR ACCOUNT DEMOGRAPHICS
TEST,ALOHA
38
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA 01/01/1980 123-45-6789 F 808-888-1234 SELF
The Coverage Wizard Query screen will open when Adding a coverage. There are slight cosmetic differences with how
you enter coverages. The Coverage Info Section will depend on the Insurance selected.
CONFIDENTIAL GUARANTOR ACCOUNT TYPE FOLDER - Cvg & Add’l Info tab 3. Confidential Adding A Coverage – a Coverage Wizard Query will open up. Type Coverage Name to Search (See Coverage Selection info in red above). **The Coverage Wizard Query steps will depend on the Insurance selected if it is EEV (electronically verifiable) or Manual verifiable (Override Query)**
4. Complete the Coverage Info as required in the selected CONF Coverage Type Folder (you will be directed to that page after CONF Coverage Selected).
If patient does not have any insurance they are considered “Self Pay”, DO NOT click Add. Patient will receive a statement.
TYPE COVERAGE NAME TO SEARCH
TEST,ALOHA
CONFIDENTIAL - USED FOR OBGYN ITOPS (TO BILL MEDICAID),
PSYCHIATRY CASES, & CLINIT SPENCER (HIV CLINIC) CASES
WILL LIST ALL ACTIVE COVERAGE FOR ALL
GUARANTOR ACCOUNTS
CONFIDENTIAL GUARANTOR ACCOUNT ADDING A COVERAGE
WILL LIST ACTIVE/INACTIVE COVERAGES FOR THE SELECTED GUARANTOR ACCOUNT TYPE (IN THE
COVERAGE SUMMARY BOX)
Certain Insurance plans can ONLY be found in CONF Guarantor Accounts.
Psych - CAMHD, United Behavioral Health, and Ohana Community Care Services (Ohana CCS) are just a few of the Insurance plans
that cannot be found in P/F, NF or WC Account Types
OBGYN ITOPS – ADD MEDICAID coverage & ensure to link to the ITOP encounter.
39
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ALOHA TEST (PATIENT)
ENTER SOMEONE ELSE
CONFIDENTIAL COVERAGE FOLDER – COVERAGE WIZARD4. Subscriber Selection box – select “Patient” - Self or “Enter Someone Else” - Other Than Self.
5. COVERAGE FOLDER - enter required fields highlighted in red. Subscriber Info – enter the Coverage Sub ID#Medicaid/HIC # - enter only if Medicaid/Quest issued ID# is different than Coverage Sub ID#Click Coverage Member Name blue-hyperlink – to enter required fields “Member Relationship to Subscriber” field if Subscriber/Policy Owner is Other Than Self and “Effective from” date field. **ENTER EFFECTIVE FROM & EFFECTIVE TO DATES FOR MEDICAID COVERAGE OBGYN ITOP SERVICES ONLY**
**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (is available on the Patient’s Registration) BUT available if the Subscriber is Other Than Self (see next slide). The Pull Info tab is okay to use in the CONF Subscriber Info Tab (if needed)**
CONF COVERAGE CLAIM ADDRESS TAB – COVERAGE WIZARD
Claim Address tab – ensure the CONF Coverage Claim Address is present.
If the fields are blank and NOT grayed out (CONF COMMERCIAL COVERAGES) – enter required fields in the “Coverage Address” section (highlighted in red).
CONFIDENTIAL COVERAGECONFIDENTIAL COVERAGE
CONFIDENTIAL COVERAGE
CONFIDENTIAL COV
0000123456
123456789
TEST,ALOHA
TEST,ALOHA 123456789
LLAGMAY (21LL1)
40
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“Subscriber Info” can be accessed on the Patient’s Registration screen under it’s Coverage Name Folder.
/ CONF COV SUBSCRIBER INFO TAB (OTHER THAN SELF) – COV WIZARD QUERY
OTHER THAN SELF
STE 123491 1234 ALAMOANA ST
(96813) HONOLULU
96813
OAHU
PULL FROM COVERAGE
F 01/01/1980
808-888-1234
UHP OF HAWAII
STE 1001677 ALA MOANA BLVD
(96813) HONOLULU
CONF SUBSCRIBER INFO TAB – Coverage Wizard Query (if Subscriber is other than Self) or Registration21. CONF SUBSCRIBER INFO TAB (OTHER THAN SELF) – enter in required fields highlighted in red (all other fields are not required, but recommended). You can click the “Pull Info” icon to pull in specific information (see above instructions).
***THE SUBSCRIBER INFO TAB WILL NOT BE AVAILABLE IN THE COVERAGE WIZARD QUERY IF SUBSRIBER IS SELF (INFO WILL AUTO-POPULATE FROM THE PATIENT’S DEMOGRAPHICS TAB). SUBSCRIBER INFO TAB CAN BE ACCESSED ON THE PATIENT’S REGISTRATION SCREEN UNDER IT’S COVERAGE NAME FOLDER**
Current Patient – pulls patient’s demographic & employer info.Guarantor – pulls guarantor’s demographic info.Another Patient – pulls demographic info from another patient in the EPIC.
Preview Info – allows you to preview the demographic info you are going to pull.All Info – pulls demographic & employer info (for Self/Patient).Address Only – pulls address & home phone info (for Other Sources/Other than Self – if diff address than pt **rel to guarantor field must be completed**
**Please be sure to pull “All Info” or “Address Only” for Guarantor Account Types & Subscriber Info
(except WC Accounts)**
**SUBSCRIBER OTHER THAN SELF/ NAME, ADDRESS, SEX & BIRTH DATE IS A REQUIRED FIELD. **
TEST,ALOHA
TEST,ALOHA
CONFIDENTIAL COV
TEST,ALOHA
41
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WORK COMP (WC) GUARANTOR ACCOUNT TYPE
42
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TEST,ALOHA
TEST,ALOHA
21600123456 - TEST,ALOHA
CLICK GUARANTOR ACCOUNTS FOLDER ON THE REGISTRATION SCREEN
CLICK MAGNIFY GLASS TO OPEN ACCUNT TYPE SELECT BOX
GUARANTOR ACCOUNT TYPE FOLDER / SELECTION – WORK COMP (WC)1. WORKERS COMP ACCOUNT TYPE FOLDER (EMPLOYER’S WC INSURANCE IS GOING TO COVER THE EXPENSES) – Click “Guarantor Accounts Folder” to “Add Guarantor Account” to Patient’s Registration (follow the steps shown above to create the WC Account Type Folder). Patients may have multiple WC injuries therefore may have multiple WC Guarantor Accounts created according to the Date of Injury (DOI).
SEE ADDITIONAL SLIDES TO COMPLETE YOUR WORK COMP GUARANTOR FOLDER
TEST,ALOHA
TEST,ALOHA
WORK COMP – EMPLOYMENT RELATED INJURY
**PATIENTS MAY HAVE MULTIPLE WC ACCOUNTS CREATED ACCORDING TO THE WC DATE OF INJURY**
43
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TEST,ALOHA
TEST,ALOHA
TA01012020
WC GUARANTOR ACCOUNT DEMOGRAPHICS
TEST,ALOHA
TA01012020
TA01012020UHPOFHI
21600123456 - TEST,ALOHA
BLANK (UNLESS REQ)
TEST,ALOHA
STE 12341234 ALA MOANA BLVD
STE 12341234 ALA MOANA BLVD
UHP OF HI
96813
96813
WORK COMP GUARANTOR ACCOUNT TYPE FOLDER - DEMOGRAPHICS2. Employer Table Selection box – Enter the Employer and DOI field as shown above (EPIC will create the “Naming Convention” for this WC Guarantor Account Folder).
3. WC Guarantor Account’s Demographics (Account type field will default to WC if this is the selected type) – EPIC will populate Employer’s info if provided in the Employer Table Selection box (Employer is listed in EPIC). For NOT ON FILE Employers, please enter required fields manually (SEE ABOVE INSTRUCTIONS). DO NOT USE THE PULL INFO BUTTON FOR WC GUARANTOR ACCOUNT DEMOGRAPHICS.
EMPLOYER TABLE SELECTION BOX - EPIC WILL AUTOMATICALLY CREATE THE “NAMING CONVENTION” OF THIS WC ACCOUNT FOLDER. THIS WILL HELP IDENTIFY THE APPROPRIATE WC ACCOUNT FOLDER FOR FUTURE VISITS
RELATED TO THIS DOI.
Enter the “Employer” field by using the magnify glass for a list of employers or type
“Not On File” to free text the employer’s name
Epic Naming Convention –Patient’s last name/first name
initial, DOI, and Employer Name. DO NOT CHANGE.
EPIC – will populateEmployer’s info into the appropriate fields (provided the Employer’s name was selected & in the EPIC system).
Not On File – please enter required Employment info fields (with red arrows) AND Patient’s Sex, DOB, & Employment status (highlighted in red) MANUALLY.
DO NOT USE THE PULL INFO BUTTON FOR WC GUARANTOR DEMOGRAPHICS.
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA 01/01/1980 123-45-6789 F 808-888-1234 SELF
The Coverage Wizard Query screen will open when Adding a coverage. There are slight cosmetic differences with how
you enter coverages. The Coverage Info Section will depend on the Insurance selected.
WORK COMP GUARANTOR ACCOUNT TYPE FOLDER - Cvg & Add’l Info tab 3. Work Comp Adding A Coverage – a Coverage Wizard Query will open up. Type WC Coverage Name to Search (See Coverage Selection info in red above). **The Coverage Wizard Query steps will depend on the Insurance selected if it is EEV (electronically verifiable) or Manual verifiable (Override Query)**
Complete the Coverage Info as required in the selected WC Coverage Type Folder through the Coverage Wizard (you will be directed to that page after WC Coverage Selected) **SEE NEXT SLIDES TO COMPLETE YOUR WC GUARANTOR ACCOUNT TYPE FOLDER**
TYPE COVERAGE NAME TO SEARCH
WILL LIST ALL ACTIVE COVERAGE FOR ALL
GUARANTOR ACCOUNTS
WORK COMP GUARANTOR ACCOUNT ADDING A COVERAGE
WILL LIST ACTIVE/INACTIVE COVERAGES FOR THE SELECTED GUARANTOR ACCOUNT TYPE (IN THE
COVERAGE SUMMARY BOX)
WORK COMP Coverages can ONLY be found in WC Guarantor Accounts and cannot be found in P/F, NF or
CONF Account Types.
TEST,ALOHA
Type the “WC Ins Comp” or “WC” for a WC payers list (in EPIC).
“WC Generic” – is used when WC Ins Comp not listed in EPIC (will need to manually enter the name & address in the “Clms Address” tab under
this WC Account Type Folder)
“WC Pending” - is used only when the patient is unable to provide WC payor info. When WC payor info received will need to add & term the
WC Pending the day before the DOI.
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ALOHA TEST (PATIENT)
TA01012020UHP OF HI(GUARANTOR/EMPLOYER)
ALOHA TEST
***THE SUBSCRIBER INFO TAB WILL NOT BE AVAILABLE IN THE COVERAGE WIZARD QUERY IF SUBSRIBER IS SELF (INFO WILL AUTO-POPULATE FROM THE
PATIENT’S DEMOGRAPHICS TAB). SUBSCRIBER INFO TAB CAN BE ACCESSED ON THE PATIENT’S REGISTRATION SCREEN UNDER IT’S COVERAGE NAME FOLDER**
WORK COMP COVERAGE FOLDER –COVERAGE WIZARD4. Subscriber Selection box – select “Patient” (For WC Accounts Patient will always be the Subscriber)
5. WORK COMP COVERAGE FOLDER - enter required fields highlighted in red. Subscriber Info – enter the WC claim # or if not given leave BLANK.Effective from – enter Date of Injury (DOI)
**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (but is available on the Patient’s Registration) The Pull Info tab for patient is okay to use in the WC Subscriber Info Tab (if needed)**
WC COVERAGE CLAIM ADDRESS TAB – COVERAGE WIZARD
Claim Address tab – ensure the WC Coverage Claim Address is present.
If the fields are blank and NOT grayed out (WC GENERIC PAYOR) – enter required fields in the “Coverage Address” section (highlighted in red).
WC CLAIM #
DOI
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LEFT WRIST
LEAVE BLANK & CLICK ACCEPT
COMPLETE THE RED
HIGHLIGHTED FIELDS IN THIS
TAB ONLY, THEN CLICK RETURN.
EPIC will create the “Claim Info Name” – WC, DOI, and Location of Injury
A RED CHECK MARK should appear to the left of the Claim ID indicating that the claim(s) has been assigned
to this visit (Click “Select” if you need to manually assign a Claim Info).
WC COVERAGE ADDITIONAL TAB TO CREATE CLAIM INFO RECORD – COVERAGE WIZARD6. CLAIM INFO RECORDS – stores additional information needed to submit specific claim(s) to the correct WC Coverage. Patients may have multiple WC Claim Records because a Claim Record is created for each Date of Injury/Circumstance. Click “Claim Info” button to create your WC Claim Info Record” by following the steps shown above.
7. WC CLM INFO RECORS box - enter required fields highlighted in red (as shown above). **CLICK “FINISH” ON THE ADDITIONAL INFO TAB WHEN YOUR WC CLM INFO RECORDS IS ASSIGNED & TO COMPLETE YOUR WC GUARANTOR ACCOUNT**
COVERAGE INFO BUTTON IS ALSO AVAILABLE IN DIFFERENT LOCATIONS ON THE REGISTRATION SCREEN.
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NO FAULT (NF) GUARANTOR ACCOUNT TYPE
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A T
TEST,ALOHA
TEST,ALOHA
21600123456 - TEST,ALOHA
CLICK GUARANTOR ACCOUNTS FOLDER ON THE REGISTRATION SCREEN
CLICK MAGNIFY GLASS TO OPEN ACCUNT TYPE SELECT BOX
GUARANTOR ACCOUNT TYPE FOLDER / SELECTION – NO FAULT (NF)1. NO FAULT ACCOUNT TYPE FOLDER (MVA) – Click “Guarantor Accounts Folder” to “Add Guarantor Account” to Patient’s Registration (follow the steps shown above to create the NF Account Type Folder). Patients may have multiple NF injuries therefore may have multiple NF Guarantor Accounts created according to the Date of Injury (DOI). **Guarantor of the account will be the Adult Patient/Self, Parent of a Minor, or Person who has Power of Attorney/Guardian**
SEE ADDITIONAL SLIDES TO COMPLETE YOUR NO FAULT GUARANTOR FOLDER
TEST,ALOHA
TEST,ALOHA
NO FAULT (NF) – MOTOR VEHICLE ACCIDENT (MVA)
**PATIENTS MAY HAVE MULTIPLE NF ACCOUNTS CREATED ACCORDING TO THE NF DATE OF INJURY**
NO FAULT
ADULT PATIENT/SELF, PARENT OF A MINOR, OR PERSON WHO HAS POWER OF ATTORNEY
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA
STE 123491 1234 ALAMOANA ST
96813
123-45-6789
F 01/01/1980
808-888-1234
Current Patient – pulls patient’s demographic & employer info.Guarantor – pulls guarantor’s demographic info.Another Patient – pulls demographic info from another patient in the EPIC.
Preview Info – allows you to preview the demographic info you are going to pull.All Info – pulls demographic & employer info.Address Only – pulls address & home phone info.
NO FAULT GUARANTOR ACCOUNT TYPE FOLDER / DEMOGRAPHICS2. Add NO FAULT Guarantor Account’s Demographics (Account type field will default to NO FAULT if this is the selected type) by A) Pulling “All Info” if it’s Self/Patient B) Pull “Address Only” for Other Sources (parent/legal guardian, emancipated minor, & person with Power of Attorney over the patient) C) You can manually enter required fields highlighted in red & if Other Source has different address than patient or patient has a different billing address “Rel to patient” must be completed.
Guar Acct Notes – Allows you to view/enter Registration
notes regarding the patient’s account which may be helpful
in researching coverage or billing inquiries.
NO FAULT
DEFAULTED OR BLANK (UNLESS REQ)
NO FAULT GUARANTOR ACCOUNT DEMOGRAPHICS
TEST,ALOHA
NO FAULT COV
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TEST,ALOHA
TEST,ALOHA
TEST,ALOHA 01/01/1980 123-45-6789 F 808-888-1234 SELF
The Coverage Wizard Query screen will open when Adding a coverage. There are slight cosmetic differences with how
you enter coverages. The Coverage Info Section will depend on the Insurance selected.
NO FAULT GUARANTOR ACCOUNT TYPE FOLDER - Cvg & Add’l Info tab 3. NO FAULT Adding A Coverage – a Coverage Wizard Query will open up. Type NF Coverage Name to Search (See Coverage Selection info in red above). **The Coverage Wizard Query steps will depend on the Insurance selected if it is EEV (electronically verifiable) or Manual verifiable (Override Query)**
Complete the Coverage Info as required in the selected NF Coverage Type Folder through the Coverage Wizard (you will be directed to that page after NF Coverage Selected) **SEE NEXT SLIDES TO COMPLETE YOUR NF GUARANTOR ACCOUNT TYPE FOLDER**
TYPE COVERAGE NAME TO SEARCH
WILL LIST ALL ACTIVE COVERAGE FOR ALL
GUARANTOR ACCOUNTS
NO FAULT GUARANTOR ACCOUNT ADDING A COVERAGE
WILL LIST ACTIVE/INACTIVE COVERAGES FOR THE SELECTED GUARANTOR ACCOUNT TYPE (IN THE
COVERAGE SUMMARY BOX)
NO FAULT Coverages can ONLY be found in NF Guarantor Accounts and cannot be found in P/F, WC or
CONF Account Types.
Type the “NF Ins Comp” or “NF” for a NF payers list (in EPIC).
“NF Generic” – is used when NF Ins Comp not listed in EPIC (will need to manually enter the name & address in the “Clms Address” tab under
this NF Account Type Folder)
“NF Pending” - is used only when the patient is unable to provide NF payor info. When NF payor info received will need to add & term the
NF Pending the day before the DOI.
TEST,ALOHA
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ALOHA TEST (PATIENT)
ENTER SOMEONE ELSE
ALOHA TEST
SUBSCRIBER FOR NF COVERAGEPATIENT/SELF – IF PATIENT IS THE SUBSCRIBER FOR THIS NF COVRAGE
ORENTER SOMEONE ELSE – IF OTHER THAN SELF / NF POLICY OWNER
**CLICK “VIEW/EDIT OTHER MEMBERS ON THIS COVERAGE” BLUE HYPERLINK TO ENTER MEMBER RELATIONSHIP TO SUBSCRIBER (REQ FIELD)**
NO FAULT COVERAGE FOLDER –COVERAGE WIZARD4. Subscriber Selection box – select “Patient” - Self or “Enter Someone Else” – Other Than Self/NF Policy Owner.
5. COVERAGE FOLDER - enter required fields highlighted in red. Subscriber Info – enter the NF claim # or if not given leave BLANK.Effective from – enter Date of Injury (DOI)View/edit other members on this coverage blue-hyperlink – enter Member Relationship to Subscriber field if Subscriber/Policy Owner is Other Than Self.
**The Subscriber Info Tab will not be available in the Coverage Wizard Query if the Subscriber is SELF (but is available on the Patient’s Registration) BUT available if the Subscriber is Other Than Self (see next slide). The Pull Info tab is okay to use in the NF Subscriber Info Tab (if needed)**
NF COVERAGE CLAIM ADDRESS TAB – COVERAGE WIZARD
Claim Address tab – ensure the NF Coverage Claim Address is present.
If the fields are blank and NOT grayed out (NF GENERIC PAYOR) – enter required fields in the “Coverage Address” section (highlighted in red).
NF CLAIM #
DOI
MEMBER RELATIONSHIP TO SUBSCRIBER FIELD REQUIRED IF SUBSCRIBER IS OTHER THAN SELF **CLICK BLUE HYPERLINK TO ENTER**
NO FAULT COVERAGE
NO FAULT COVERAGENO FAULT COVERAGE
NO FAULT COVERAGE
NO FAULT COVERAGE
NO FAULT COVERAGE
SEE NEXT SLIDE
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“Subscriber Info” can be accessed on the Patient’s Registration screen under it’s Coverage Name Folder.
/ NF COV SUBSCRIBER INFO TAB (OTHER THAN SELF) – COV WIZARD QUERY
OTHER THAN SELF/NO FAULT POLICY OWNER
STE 123491 1234 ALAMOANA ST
(96813) HONOLULU
96813
OAHU
NF CLAIM #
F 01/01/1980
808-888-1234
UHP OF HAWAII
STE 1001677 ALA MOANA BLVD
(96813) HONOLULU
SUBSCRIBER INFO TAB – Coverage Wizard Query (if Subscriber is other than Self) or Registration21. SUBSCRIBER INFO TAB – enter in required fields highlighted in red (all other fields are not required, but recommended). You can click the “Pull Info” icon to pull in specific information (see above instructions).
***THE SUBSCRIBER INFO TAB WILL NOT BE AVAILABLE IN THE COVERAGE WIZARD QUERY IF SUBSRIBER IS SELF (INFO WILL AUTO-POPULATE FROM THE PATIENT’S DEMOGRAPHICS TAB). SUBSCRIBER INFO TAB CAN BE ACCESSED ON THE PATIENT’S REGISTRATION SCREEN UNDER IT’S COVERAGE NAME FOLDER**
Current Patient – pulls patient’s demographic & employer info.Guarantor – pulls guarantor’s demographic info.Another Patient – pulls demographic info from another patient in the EPIC.
Preview Info – allows you to preview the demographic info you are going to pull.All Info – pulls demographic & employer info (for Self/Patient).Address Only – pulls address & home phone info (for Other Sources/Other than Self – if diff address than pt **rel to guarantor field must be completed**
**Please be sure to pull “All Info” or “Address Only” for Guarantor Account Types & Subscriber Info (except WC Accounts)**
**SUBSCRIBER OTHER THAN SELF/NO FAULT POLICY OWNER NAME, ADDRESS, SEX & BIRTH DATE IS A REQUIRED FIELD. EMPLOYMENT INFO (IF APPLICABLE) – OF THE POLICY OWNER OF THE VEHICLE**
TEST,ALOHA
TEST,ALOHA
TEST,ALOHA
NO FAULT COVERAGE
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LEAVE BLANK & CLICK ACCEPT
COMPLETE THE RED
HIGHLIGHTED FIELDS IN THIS
TAB ONLY, THEN CLICK RETURN.
NF COVERAGE ADDITIONAL TAB TO CREATE CLAIM INFO RECORD – COVERAGE WIZARD6. CLAIM INFO RECORDS – stores additional information needed to submit specific claim(s) to the correct NF Coverage. Patients may have multiple NF Claim Records because a Claim Record is created for each Date of Injury/Circumstance. Click “Claim Info” button to create your NF Claim Info Record” by following the steps shown above.
7. NF CLM INFO RECORS box - enter required fields highlighted in red (as shown above). **CLICK “FINISH” ON THE ADDITIONAL INFO TAB WHEN YOUR NF CLM INFO RECORDS IS ASSIGNED & TO COMPLETE YOUR NF GUARANTOR ACCOUNT**
COVERAGE INFO BUTTON IS ALSO AVAILABLE IN DIFFERENT LOCATIONS ON THE REGISTRATION SCREEN.
NO FAULT COVERAGE
EPIC will create the “Claim Info Name” – NF, DOI, and Location of Injury
A RED CHECK MARK should appear to the left of the Claim ID indicating that the claim(s) has been assigned
to this visit (Click “Select” if you need to manually assign a Claim Info).
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REGISTRATION ADDITIONAL INFORMATION
ANDRESOURCES
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VISIT FILING ORDER (VFO)
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12345678
TEST,ALOHATEST,ALOHA (21600123456)
TEST,ALOHA
21600123456-TEST,ALOHA 21600123456-TEST,ALOHA
VISIT FILING ORDER (VFO) – Patient Name Folder (Visit Info Tab)VISIT FILING ORDER (VFO) - The ability to individually designate the filing order of coverages for visits/encounters. You can add an unused coverage, remove coverage(s), and adjust the filing order by using the up and down arrows. It is important to remove coverages if they should NOT be billed for the visit/encounter.
**The “Visit Account and Filing Order” button will be grayed out when accessed through Registration and not through Scheduling**
Please be sure to verify coverages, filing order, & complete the VFO before charges are filed.
Guarantor Account – make sure the appropriate Guarantor Account is selected (PF, CONF, WC, No Fault)Visit Coverages (Overridden) / Unused Coverages –A) Click on the “+” in the Unused Coverages section if coverage should be linked to the encounter.B) Click on “X” to not use coverage(s) for this encounter (remember to remove coverages such as VA or VA Triwest if they should not be billed for this visit).C) Click on “Use Default Coverages” if all coverages should be linked.D) Click in “Do not bill insurance” box if no insurance to be billed (SELF PAY)E) Click the up & down arrow to adjust the filing order.
THE VFO WILL BE LOCKED & NO CHANGES CAN BE MADE BY THE PSR IF:CHARGE FILED, COPAY FILED, OR COPAY & CHARGE FILED (THIS WILL SHOW ON TOP LEFT) **CAN ONLY BE ACCESSED ON THE BACK END (BILLING/MANAGEMENT)**
IF THE MSPQ IS COMPLETED PRIOR TO BILLING, COV WILL CHANGE BASED UPON MSPQ
RESULTS. MESSAGE WILL SHOW IF A USER APPLIES OR
OVERRIDES MSPQ RULES.
Visit Filing Order (VFO)– will be grayed out if you are doing straight Registration and not going through Appt Scheduling.
VFO (THROUGH APPT SCHEDULING) –THIS IS WHER TO LINK THE COVERAGE
TO THE VISIT/APPT AFTER YOU COMPLETE ALL REGISTRATON
FOLDERS/TABS (COVERAGES ADDED)
MOVE COVERAGE UP ONE POSITION
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Mahalo for joining us!
For any Registration & Insurance questions please contact:ERIN – [email protected] or Ph# 469-4936
LESA – [email protected] or Ph# 469-4918 (Ins Access Admin)
All other billing questions: [email protected] or Ph# 469-4900
Find us online at: http://uhphawaii.org/index.php/UHPCBO
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mailto:[email protected]
Slide Number 1Slide Number 2 NEW PATIENT INTERACTIVE FACE SHEET – REGISTRATION/PATIENT’S NAME FOLDER DEMOGRAPHICS TAB – Registration/Patient’s Name FolderPCP / EMPLOYER TAB – Registration/Patient’s Name Folder Slide Number 7VISIT INFO TAB – VISIT FILING ORDER (VFO) RESEARCH TAB – Registration screenGUARANTOR ACCOUNTS FOLDER (GUARANTOR ACCOUNT TYPES FOLDER)GUARANTOR ACCOUNT TYPE FOLDER (DEMOGRAPHICS)COVERAGE & ADDITIONAL INFO TAB (GUARANTOR ACCOUNT TYPE FOLDER) COVERAGE SELECTION & SUBSCRIBER SELECTION BOX– COVERAGE WIZARD QUERYELIGIBILITY QUERY – COVERAGE WIZARD QUERYE-VERIFICATION RESPONSE NOTIFICATION – COVERAGE WIZARD QUERY “E-REJECTED / COULD NOT BE PROCESSED”COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (HMSA COVERAGE)COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (TRADITIONAL MEDICARE) COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (MEDICARE ADVANTAGE PLANS)COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (QUEST INTEGRATION ABD/NON ABD)COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (UHC COMM MEDICARE DUAL (MEDI/MEDI)COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (QST INT UHC COMM MEDICAID (MEDI/MEDI)COVERAGE NAME FOLDER – Coverage Wizard Query or Registration (UHA COVERAGE)COVERAGE NAME TAB – Coverage Wizard Query or Registration (HEALTHNET TRICARE PLANS) COVERAGE NAME TAB – Coverage Wizard Override Query (VA CCN -TRIWEST HEALTHCARE ALLIANCE)SUBSCRIBER INFO TAB – Coverage Wizard Query (if Subscriber is other than Self) or RegistrationCLAIM ADDRESS TAB – Coverage Wizard Query or Registration (Coverage Name Folder)ADDITIONAL INFO TAB – Coverage Wizard Query or Registration (COVERAGE SCAN)CVG & ADD’L INFO TAB – Registration (Guarantor Account Type Folder) COVERAGES FOLDER / COVERAGE NAME FOLDERS– Registration (FILLING ORDER)REGISTRATION SCREEN – INTERACTIVE FACE SHEET (CLICK PATIENT’S NAME FOLDER)INTERACTIVE FACESHEET – RegistrationREGISTRATION SCREEN – INTERACTIVE FACE SHEET (PATIENT’S NAME FOLDER)REGISTRATION SCREEN – INTERACTIVE FACE SHEET (PATIENT’S NAME FOLDER)Slide Number 35Slide Number 36Slide Number 37CONFIDENTIAL GUARANTOR ACCOUNT TYPE FOLDER / DEMOGRAPHICSCONFIDENTIAL GUARANTOR ACCOUNT TYPE FOLDER - Cvg & Add’l Info tab CONFIDENTIAL COVERAGE FOLDER – COVERAGE WIZARDCONF SUBSCRIBER INFO TAB – Coverage Wizard Query (if Subscriber is other than Self) or RegistrationSlide Number 42GUARANTOR ACCOUNT TYPE FOLDER / SELECTION – WORK COMP (WC)WORK COMP GUARANTOR ACCOUNT TYPE FOLDER - DEMOGRAPHICSWORK COMP GUARANTOR ACCOUNT TYPE FOLDER - Cvg & Add’l Info tab WORK COMP COVERAGE FOLDER – �COVERAGE WIZARDWC COVERAGE ADDITIONAL TAB TO CREATE CLAIM INFO RECORD – COVERAGE WIZARDSlide Number 48GUARANTOR ACCOUNT TYPE FOLDER / SELECTION – NO FAULT (NF)NO FAULT GUARANTOR ACCOUNT TYPE FOLDER / DEMOGRAPHICSNO FAULT GUARANTOR ACCOUNT TYPE FOLDER - Cvg & Add’l Info tab NO FAULT COVERAGE FOLDER – �COVERAGE WIZARDSUBSCRIBER INFO TAB – Coverage Wizard Query (if Subscriber is other than Self) or RegistrationNF COVERAGE ADDITIONAL TAB TO CREATE CLAIM INFO RECORD – COVERAGE WIZARDSlide Number 55Slide Number 56VISIT FILING ORDER (VFO) – Patient Name Folder (Visit Info Tab)Mahalo for joining us!