Memos Tab

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The memos tab is used to remind you of important topics you may need to take into consideration before you give your answer to the patient. Please take the time to read them carefully right after the verification. 

 You may find many different memos; the following are the most frequent ones:

 

AUTHORIZED USERS 

  • Make sure you are talking to the same person that’s on the memo and authenticate the account with the pieces of information you need.  
  • You may find accounts that have the authorized user’s DOB instead of the phone number and that’s ok! 
  • When leaving an authorized user memo, please also add it to your notes.  

 E.g:  PT AUTHORIZED HUSBAND JOHN DOE, PHONE # 555-555-5555

  

 

OA100 CHECKS 

  • These bills are usually divided into 2 amounts: The check amount and patient responsibility Please remember checks CANNOT be negotiated! The same exact amount that the check was issued for, is the same amount that needs to be paid; now, for the patient responsibility portion, could be negotiated ONLY IF the patient requests it and it’s always according to the Walkdown document; otherwise attempt to collect the full amount.  

E.g:  CASE 0000000 – OA100: $1500 + PR: $749

This means that the patient NEEDS to pay a total of $2249. the $1500 CANNOT be negotiated but, the $749 could be negotiated ONLY IF the patient requests it.  

 See the OA100 process to get more details

 

 SPECIAL PRICES APPROVED 

  • When you find memos with special prices, there’s no need to ask for authorization anymore, you just need to honor them.  
  • These could be courtesy exceptions, prices quoted by the clinic or CFS and even by agents.  
  • Regardless of what the original bill is, you just need to take what’s in the memo and AFTER you have taken the payment, you may need to send a ZBAL request.  
  • It’s important you check the memos tab before you tell your patient what’s their total to avoid misunderstandings.  

 E.g:  Please honor $249 / Clinic quoted $99 / Courtesy exception $0 / CFS Jennifer Nagro approved $149 

 

 

COMPASSIONATE CARE 

  • Approximately 5 business days after patients have applied correctly for the program, you will be able to find memos and/or notes with the amount they were approved for and an approval code. This is the ONLY valid confirmation that patients were approved for the program.  
  • It could happen that your patient says they have an approval code; ask probing questions to determine if it’s the online form’s confirmation which is alphanumerical and NOT an approval code.  
  • The correct approval has only numbers! it’s important that you have a memo, note or that your CSS is able to find the confirmation in Sales Force.  

 E.g:  COMP CARE APPROVED 100%. SF# 99999999

 See Compassionate Care Process for more details

 

 OFFSHORE CASES 

  • If the patient has listed one of the insurance companies we don’t work with, you will find a memo.  
  • Billing agents won’t be able to continue assisting or even leave notes (this is the only exception to the rule) 
  • Send the Offshore Cases escalation form and advise of contact turnaround time. 
  • REGARDLESS if the case has memos or not, it’s always a good idea to check the insurance tab and LIMS for any MI patient to avoid mistakes.

E.g:  CASE NOT TO BE WORKED OFFSHORE. PLEASE CLOSE IF YOU ARE NOT PART OF THE US TEAM

 See Offshore process for more details

 

 UHC AND CIGNA LEVEL 2 

  • Cases that have been flagged will have 100% of the times a memo or note. 

E.g:  UHC 2ND LEVEL APPEAL. AGENTE TO USE 2ND LEVEL APPEAL SCRIPT.  

See the UHC and Cigna level 2 process for more details

 

BILLING ERROR LETTER 

  • Due to a system error, Natera inadvertently mailed an invoice to patients before the claim was completed. If the patient was affected, you will find a memo. Only 4,500 cases were affected. 
  • You need to follow the following script: “Due to a system error, Natera mailed an invoice to you for the genetic test you recently completed. Please disregard it as we have submitted a claim to your insurance company and you should expect to receive an explanation of benefits in approximately 30-45 days.” 

 E.g:  Self-Pay Invoice Mailed in Error – Follow billing error script

 

 CORRECTED CLAIM 

  • This memo means that there was an error with the CPT codes Natera reported to the insurance on the initial claim.  
  • Follow the script and attempt to take the payment for the full amount on the bill.  
  • ONLY if necessary, follow your Walkdown document.  

 E.g:  HORIZON CORRECTED CLAIM – FOLLOW SCRIPT

 See the Horizon Corrected Claim process for more details

 

 

Last update by: Claudia F (August 7, 2024)

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