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Claim Management (Admin (Team Meetings (Pod Mtg, Weekly Scrum, Regional…
Claim Management
Admin
Msg Center (Practice Communication)
Jira
Fax Monitoring
Internal Communication (Slack)
Team Questions
Team Meetings
Pod Mtg
Weekly Scrum
Regional Meeting (Monday)
1:1 Every Other Week
Submit Claim
Initial
Auto (0 Effort)
Electronic (Manual Review)
Secondary
Tx in Progress
w/ Electronic Attachment
Print/Mail
Continuation
Product Submits (Easy)
High Touch (Claims Team)
Escalation Management
Unhandled by Argo
Follow Up Managment
Needs Attention
Intake First Pass Responses
Denials
Rejected By Clearinghouse
Rejected by Carrier
Open
Resubmit
Corrected Claim
Initial Claim Not Received
Rejected
Appeal
Timely Filing
In/Out Netowkr
Verified by Carrier (Differences from Eligibility)
First Pass Claim Review
Initial Payment
Recurring Payment
Plan Terminated
All Benefits Paid
RFI
Future Payment Scheduled
Payment Already Sent
Annual Max Met
Other
PPA Sendback
Confirm Payment Information