Inbasket/Referrals/HBC

What does HBC stand for?

Hospital-Based Clinic: Which refers to a healthcare facility that follows Hospital Billing and provides outpatient services.

Do you need to grab the baton for In basket messages?

If there’s more than one person in there from the Specialty team, it is good to do, so double work doesn’t occur

What is the verification status for specialty coverages?

Manually verified

Where do you In basket messages come from?

In basket messages come from various sources such as referrals, Departments/Clinics/Hospitals, or internal team messages, aimed at facilitating coordination and communication within the healthcare team.

What should the subscriber name of a WC coverage be?

The employer

What is a good tool to use when you’re searching for WC coverage?

DOLI

In HBC, what do you need to make sure you check with every account?

The PB side using the more drop down in Enc Guar and Cvgs

What do you do if you see Medicare Part A?

Unattach

What is the functionality of a referral message?

To provide us with necessary information that is needed in order for the patient to be seen and have services covered, as well as to be able to build coverage appropriately

Rightfax is just another avenue to receive pertinent patient information from different departments across Allina. True or False?

True

What is necessary for an HBC account to have to be able to work it?

A HAR

If a HAR is needed, and prior to the apt, what do we do?

Create an appointment note , and enter “HAR note” in WQ, and defer 1 day

Which account classes do you need to escalate?

Recurring Outpatient and Perpetual Outpatient

What is the plan code for Medicare Part B?

232

Do we verify Mental health Carve Out plans in HBC?

No

You are working an HBC account with Medicare Part B and Blue Cross Platinum Blue HB only coverage attached. What coverage should be attached on the PB side?

Blue Cross Platinum Blue MR -PB only

What should be prioritized/worked first? Referral messages or Staff Messages?

Referral Messages

If there is not enough information to add/verify specialty coverage from a referral message, do we send a message back?

Yes, we send a message back to request more information.

When working referral messages, what smartphrase can you use?

In the Inbasket workflow: (.CVTINBASKET)

What avenues can we use to document while in HBC?

Appointment messages, WQ notes, and Guarantor notes