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