Co- Insurance Co- Insuranc Living Will Commercial Appointment Desk Subscriber Subscriber Ineligible PCP VA Tricare Deposit Address TPL Ethnicity HIPPA Doctor Guarantor Payment Cigna BCBS Age Active EPIC Hospital Access Referral Thank you RCO Registration Authorization and Service Term PFFS Customer Service Co- Pay Deductible COB ESTIMATE ICN Nurse Allowed Amount Patient Station Pending Advanced Directive Discharge Pre- Admit PPO Lab Medicaid SELF- PAY Medicare WQ'S ROI Coverage Demographics D Consent CPT Room Admit Religion Effective Date Patient Encounter Authorization Check- out Payer DOB Aetna Clinic Email HAR Check- in Co- Insurance Co- Insuranc Living Will Commercial Appointment Desk Subscriber Subscriber Ineligible PCP VA Tricare Deposit Address TPL Ethnicity HIPPA Doctor Guarantor Payment Cigna BCBS Age Active EPIC Hospital Access Referral Thank you RCO Registration Authorization and Service Term PFFS Customer Service Co- Pay Deductible COB ESTIMATE ICN Nurse Allowed Amount Patient Station Pending Advanced Directive Discharge Pre- Admit PPO Lab Medicaid SELF- PAY Medicare WQ'S ROI Coverage Demographics D Consent CPT Room Admit Religion Effective Date Patient Encounter Authorization Check- out Payer DOB Aetna Clinic Email HAR Check- in
(Print)
Co-Insuranc
Living Will
Commercial
Appointment Desk
Subscriber
Ineligible
PCP
VA
Tricare
Deposit
Address
TPL
Ethnicity
HIPPA
Doctor
Guarantor
Payment
Cigna
BCBS
Age
Active
EPIC
Hospital
Access
Referral
Thank you
RCO
Registration
Authorization and Service Term
PFFS
Customer Service
Co-Pay
Deductible
COB
ESTIMATE
ICN
Nurse
Allowed Amount
Patient Station
Pending
Advanced Directive
Discharge
Pre-Admit
PPO
Lab
Medicaid
SELF-PAY
Medicare
WQ'S
ROI
Coverage
D
Consent
CPT
Room
Admit
Religion
Effective Date
Patient
Encounter
Authorization
Check-out
Payer
DOB
Aetna
Clinic
Email
HAR
Check-in
