CRCR Unit 2:(Pre-Service Financial
Care)
Types of Unscheduled Patients (Ans- Urgent (ED) patients, Walk-in OP, Observation patients, and newborns.
Resource Coordination (Ans- The process of reserving rooms and/or equipment, ordering devices or supplies, and ensuring that professional staff (physicians, nurses, and/or technicians) are available for when a patient arrives.
Patient Scheduling Core Concepts (Ans- Patient Identification, Requested Service, Scheduling Instructions, Review and Validation, Patient Reminders and Arrival Instructions, Order Requirements
270 Healthcare Eligibility Benefit Inquiry (Ans- Outbound inquiry from the provider to the health plan to confirm a patient's eligibility.
Tricare (Ans- Healthcare program of the US Department if Defense Military Health System
Indian Health Service (IHS) 1 / 2
(Ans- Agency within the the DHHS which is responsible for providing federal health plans to Native Americans.
Medicaid (Ans- Federally-aided, state-operated program to provide health and long term care coverage for low-income individuals or families
Medicare (Ans- Government-sponsored program financed through taxes and general revenue funds.
Managed Care Plans (Ans- Comprehensive healthcare plans that attempt to reduce costs through contractual agreements with providers and through care management initiatives.
Commercial Indemnity Plans (Ans- Cover almost all services without authorization requirements.
Blue Cross / Blue Shield (Ans- Nation's oldest and largest family of health benefits companies.
Self-insured plans (Ans- Self funded plan where the costs of medical care are borne by the employer on a pay as you go basis.
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