Patient Access Department - Registrar Competency Exam

If a patient demonstrates a language barrier or requests and interpreter, HNH is required to provide one. The Language Line may be accessed by dialing '0' and asking the HNH operator to connect you with an interpreter in the appropriate language. HNH employees may NOT use non-clinical staff for interpretation in a clinical setting.

True- During a declared disaster, the Triage Tag number (found repeating throughout the Triage Tag) should be used as the patient's main identifier.

The primary insurance policy for the 8-year-old patient will be determined by the "birthday rule." The birthday rule states that the parent whose birthday (month and day) occurs earlier in the calendar year has the primary insurance coverage for the child.

In this case:

Mother's DOB: 04/10/1970

Father's DOB: 01/17/1969

Since January 17 (Father's birthday) comes before April 10 (Mother's birthday) in the calendar year, the father's insurance policy (Oxford) would be considered primary.

The number of employees at their respective workplaces does not affect the determination of the primary insurance in this context; it's the birthday rule that applies.

Medicare beneficiaries are entitled to receive Medicare benefits because of their age, a disability, or ESRD (End Stage Renal Disease).

In the Korean culture, most first names are composed of 2 names- there are no middle names. Both first names, Yoo and Ki should be entered together as the first name. NOTE: If the patient's LEGAL ID separates the names, you must follow what the ID dictates.

EMTALA states that all Emergency Room patients and any patient in active labor must be treated and stabilized regardless of their ability to pay.

Since Medicare part A only covers inpatient services, this patient should be registered as Self-Pay.

If a patient is involved in a motor vehicle accident and is covered under a MVA policy, the MVA must be billed. If the patient has medical insurance, that policy is billed as secondary.

The Joint Commission requires a minimum of three patient identifiers when confirming a patient's identity. Registrars should only select a patient record only when three identifiers have been confirmed by the patient and/or family.

The patient should be registered as John Anthony Smith III because this is the name that appears on the NJ Driver's License, which is the most official form of identification among the three cards provided. The work ID, which reads Johnny Smith, may not be the patient's legal name and should not be used for registration purposes. The insurance card, which reads John Smith III, may also not be the patient's full legal name as it does not include the middle name "Anthony" that is present on the driver's license. Therefore, the name on the driver's license should be used for registration.

Medicare Part B may be used for both inpatient and outpatient services when the patient has part B only.

Per Patient Access rules, if a patient has more than one CONFIRMED medical record, the lowest number must be chosen. All others should be flagged for duplicates.

The patient's Aetna commercial policy would be considered the primary insurance in this case. This is because the patient states that the Aetna policy is provided through his wife's job at Walmart, indicating that it is an employer-sponsored insurance plan. Employer-sponsored plans are typically considered primary over Medicare, which is a government-funded insurance program.

Since a Social Security number is a unique identifier, it is best to begin a patient search with this number. If no matches are found, a name search should follow.

The patient is 45 years old and disabled, receiving Social Security benefits as a result of a back injury. Medicare is a federal health insurance program for individuals who are 65 years or older, or individuals under 65 who have certain disabilities. Given that the patient is disabled and receiving Social Security benefits, it is likely that he qualifies for Medicare. The information provided does not indicate any specific eligibility for Cigna insurance, therefore Medicare is the primary insurance for this patient.

Per Patient Access Rules, name searches should be performed by entering the first three letters of the first and last name only. The DOB should be entered as well to narrow the search and increase accuracy.

When billing for healthcare services for a patient who has multiple types of insurance, the order in which insurers are billed is determined by coordination of benefits rules. For Mr. Bradley Pitt, who has Medicare, a BCBS (Blue Cross Blue Shield) Medigap policy, and NJ Medicaid, the correct order of payors would be:



Medicare as the primary insurance because it is the federal health insurance program for people who are 65 or older, among others. As Mr. Pitt is 87 years old, Medicare would be his primary coverage.



BCBS Medigap as the secondary insurance. Medigap is a Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Medigap policies can help pay some of the remaining health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.



NJ Medicaid as the tertiary insurer. Medicaid would be the payer of last resort after Medicare and any other insurance (like Medigap) have paid. Medicaid programs can help pay for costs not covered by Medicare and Medigap.



Therefore, the correct order should be Medicare, BCBS, Medicaid.