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WorksheetsHIPAA and LINK
Total questions: 10
Worksheet time: 4mins
What are the non-negotiable initial HIPAA verifiers?
Date of birth
SSN
Member ID
Full name of the patient
If HIPAA is NOT verified, can you still continue creating the case, linking the case?
No
Yes
Maybe
What are you going to do if you are unable to verify HIPAA?
(a)
Can you use the address if the DOB is not given?
Yes
No
If the patient's first name on fax is a nickname + last name, can we still tag ACMS as HIPAA Verified?
Yes
No
What are the pieces of information you need/can use to know if you can link the fax to a case on file?
Servicing Provider
Facility Name
Type of Service and Request Type
Authorization Number
Notes
If you have the UM reference number, you only need 3 additional information to validate if the fax can be linked or not
Not really
Yes
No
UM Reference Number, Servicing provider and DOS are matching but not the Facility, can you still link the DCN to an existing case on file?
Yes
No
Facility Name match together with the UM Reference Number but not the CPT code and the date of service, what are you going to do?
Link the DCN
Create a new case
Add the DCN they i will just cancel the case
If case is cancelled as duplicate, you need to
Check for any active case on file that matches and attach the fax
Do not reopen the case, just link on the quick links to attach and document
Wrap up the case and tag no review needed
