Syllabus

HomeAR Caller Syllabus

AR CALLER

An "Accounts Receivable (AR) caller" typically refers to a person or a department responsible for making phone calls to customers who owe money to a business or organization.

What is AR CALLER?

  • Invoice Clarification
  • Payment Collection
  • Record Keeping
  • Customer Service
  • Reporting
  • Contacting Customers

RCM CYCLE

  • Patient Pre-Registration
  • Insurance Verification
  • Patient Check-In
  • Medical Coding
  • Charge Entry
  • Claim Submission
  • Payment Posting
  • Denial Management
  • Patient Billing and Collections
  • Payment Reconciliation
  • Financial Reporting and Analysis
  • Patient Follow-Up

Current Procedural Terminology

  • Cpt code v-1
  • Cpt code v-2
  • Cpt code v-3

The levels of cpt code

  • Level I
  • Level ii
  • Level III

The encounter process?

Transcription process

Dx code (diagnosis code)/ illness/ sickness

Types of insurences

  • Place of service
  • Tos (type of service)
  • Timely filing limit (tfl)

3’s in us Medical Coding

  • ICD-10 (International Classification of Diseases, 10th Edition) Codes
  • CPT (Current Procedural Terminology) Codes
  • HCPCS (Healthcare Common Procedure Coding System) Codes

Patient demo entry

  • The Patient name
  • Patient SSN
  • Patient Phone No

Patient demo entry

  • The Patient name
  • Patient SSN
  • Patient Phone No

In Network Provider

  • Out of network provider
  • ABN (advance beneficiary notice)
  • AOB (assignment of benefits)
  • ROI (release of information)
  • COD (coordination of benefits)
  • Refund
  • Recoupement /Offset
  • Capitation
  • Pre-determination
  • Auth – prior and retro authorization
  • Referral

The types of insurances

  • Federal insurance : medicare and Medicaid The medicare crossover
  • The Commercial insurance
  • The workers compensation insurances
  • Liability Insurances
  • Collision Insurances

The claim adjudication

  • The initial processing review
  • The automatic review
  • The manual review
  • The payment determination

The payment posting

  • The explanation of benefits
  • The payment posting
  • Billed amount
  • Allowed amount
  • Fee scheduled
  • The contractual adjustment

The denials

  • The authorization denial
  • Duplicate denial
  • Bundle denial
  • Referral denial
  • Need primary eob denial
  • policy exhausted
  • Timely filing limit denial
  • Noncovered services
  • Additional information needed
  • Coordination of benefits denial