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Patient & Account Management

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Finding Patients

  • “Find patient John Smith born 03/15/1985”
  • “Search for patient with phone number (555) 123-4567”
  • “Look up patient ID [ID]”
  • “Find patient Maria Garcia with DOB 07/22/1990”
  • “Search for patient by last name Johnson”
  • “Locate patient with member ID ABC123456”
  • “Find patient Robert Chen born in 1975”
  • “Search for patient with phone ending in 4567”
  • “Look up patient Sarah Williams ID [ID]”
  • “Find patient with preferred name Mike instead of Michael”

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Patient Demographics & Insurance

  • “Show me patient [ID]‘s demographics and insurance information”
  • “Get all insurance details for patient John Smith”
  • “What insurance does patient Maria Garcia have on file?”
  • “Show me the complete profile for patient ID [ID]”
  • “Display demographics and coverage for patient Chen”
  • “Get patient Williams’ address and insurance information”
  • “Show me all details for patient Anderson including insurances”
  • “What’s the primary insurance for patient Johnson?”
  • “Display patient [ID]‘s contact information and coverage”
  • “Get complete patient information for Garcia including all insurances”
  • “Show me patient Smith’s demographics and active insurance policies”
  • “What insurance information do we have for patient ID [ID]?”

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Account Analysis & Balance Breakdown

  • “Show me the complete balance breakdown for patient John Smith”
  • “Why does patient Maria Garcia have a balance?”
  • “Analyze all charges and payments for patient Robert Chen from January to March 2024”
  • “What credits does patient Sarah Williams have available?”
  • “Show me the payment history for patient ID [ID]”
  • “Break down the outstanding balance for patient Johnson”
  • “Explain the charges on patient Garcia’s account from last month”
  • “What’s the total amount owed by patient Smith across all dates of service?”
  • “Show me all unpaid charges for patient Chen from 2024”
  • “Analyze the credit balance for patient Williams - why do they have a credit?”
  • “Review all transactions for patient ID [ID] in the last 6 months”
  • “What’s causing the high balance alert for patient Anderson?”
  • “Show me the detailed breakdown of patient [ID]‘s charges from 01/01/2024 to 03/31/2024”
  • “Analyze patient Garcia’s credits history and current available credits”

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Patient Account Actions

  • “Write off $150 balance for patient John Smith - reason: financial hardship”
  • “Refund $75 cash payment for patient Maria Garcia - duplicate payment”
  • “Update insurance information for patient Robert Chen - new policy number ABC123”
  • “Write off $200 for patient ID [ID] due to billing error”
  • “Process refund of $50 credit card payment for patient Williams - overpayment”
  • “Update patient Garcia’s secondary insurance to Aetna”
  • “Write off copay balance of $25 for patient Smith - sliding fee patient”
  • “Refund $100 check payment for patient Chen - services not rendered”
  • “Add new primary insurance for patient ID [ID] - Blue Cross policy XYZ789”
  • “Write off deductible amount of $300 for patient Johnson - charity care”
  • “Process partial refund of $40 for patient Anderson - insurance adjustment”
  • “Update group number for patient Williams’ insurance to GRP456”
  • “Create new insurance for patient [ID] with Cigna policy number POL123”
  • “Show me sliding fee history for patient Smith”

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Claims & Encounter Management

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Finding Encounters

  • “Show me all encounters for patient John Smith in 2024”
  • “Find encounters from 09/01/2024 to 09/30/2024 for Dr. Johnson”
  • “List all denied encounters for patient Maria Garcia”
  • “Show encounters for patient ID [ID] from last month”
  • “Find all encounters with Dr. Chen as rendering provider this week”
  • “List encounters for patient Williams between 06/01/2024 and 08/31/2024”
  • “Show me all pending encounters for patient Anderson”
  • “Find encounters with billing errors from October 2024”
  • “List all completed encounters for Dr. Smith from yesterday”
  • “Show encounters for patient Garcia with secondary insurance claims”
  • “Find all encounters awaiting primary insurance response”
  • “List encounters for patient ID [ID] with outstanding balances”
  • “Show me encounters for provider ID [ID] from last week”
  • “Find all encounters with billing status issues”

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Encounter Details & Analysis

  • “Get full details for encounter ID [ID] including billing summary”
  • “Show me the timeline for patient Smith’s visit on 08/15/2024”
  • “What’s the current status of encounter [ID]?”
  • “Explain the denial reason for encounter [ID]”
  • “Show billing summary for encounter ID [ID]”
  • “What procedures were billed on encounter [ID]?”
  • “Review the claim history for encounter [ID]”
  • “Show me all diagnosis codes for encounter [ID]”
  • “What insurance was billed for encounter [ID]?”
  • “Explain the submission error on encounter [ID]”
  • “Show me the provider and facility for encounter [ID]”
  • “What’s the total charge amount for encounter [ID]?”
  • “Review the payment posting for encounter [ID]”
  • “Get the date of service timeline for patient [ID] on 2024-08-15”
  • “Show me claim details for claim ID [ID] with billing breakdown”

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EOB Processing

  • “I want to create an EOB from this attached file”
  • “Process EOB posting from the uploaded remittance file”
  • “Create EOB from the insurance payment document I attached”
  • “Upload and process this EOB file for payment posting”
  • “I have an EOB file to process - can you handle it?”
  • “Create EOB posting from the attached insurance remittance”
  • “Process the EOB document I just uploaded”
  • “Handle EOB creation from this insurance payment file”
  • “I need to process an EOB from the attached document”
  • “Create EOB posting from this remittance advice file”

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Appointment Operations

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Searching Appointments

  • “Show me all appointments for Sarah Wilson today”
  • “Find appointments for patient John Smith in October 2024”
  • “List all cancelled appointments this week”
  • “Show me no-show appointments from last month”
  • “Find appointments for Dr. Johnson on 10/31/2024”
  • “List all completed appointments for patient Garcia yesterday”
  • “Show scheduled appointments for patient ID [ID] next week”
  • “Find all appointments at Main Street facility today”
  • “List appointments for patient Chen between 09/01 and 09/30”
  • “Show me all confirmed appointments for tomorrow”
  • “Find physical therapy appointments for patient Williams”
  • “List all appointments with Dr. Anderson this month”
  • “Show me checked-in appointments for today”
  • “Find appointments for patient Smith from 2024-10-01 to 2024-10-31”

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Appointment Analysis & Charges

  • “What are the suggested charges for appointment ID [ID]?”
  • “Show me copay and coinsurance amounts for appointment [ID]”
  • “Analyze collections for all appointments on 10/15/2024”
  • “What’s the deductible amount for appointment [ID]?”
  • “Show suggested charges for patient Smith’s appointment today”
  • “Review copay collection for appointment ID [ID]”
  • “What insurance benefits apply to appointment [ID]?”
  • “Show me the sliding fee discount for appointment [ID]”
  • “Analyze pre-visit charges for appointment [ID]”
  • “What’s the patient responsibility for appointment [ID]?”
  • “Review coinsurance calculation for appointment [ID]”
  • “Show me all charge suggestions for appointment [ID]”
  • “What payment is due at time of service for appointment [ID]?”
  • “Get suggestions and collections for appointments [ID], [ID], [ID]”
  • “Show me detailed charge breakdown with rules for appointment [ID]“

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Appointment Types & Facilities

  • “What appointment types are available at this site?”
  • “Show me all facilities for this location”
  • “Find facility information for Downtown location”
  • “List all available appointment types for scheduling”
  • “What facilities can I schedule appointments at?”
  • “Show me facility details for Main Street location”
  • “What are the different appointment types we offer?”
  • “Find facility ID for the Westside clinic”
  • “List all active facilities for patient scheduling”
  • “What appointment types should I use for physical therapy?”

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Provider Management

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Finding Providers

  • “Find provider Dr. Sarah Johnson”
  • “Look up provider with NPI 1234567890”
  • “Search for provider Michael Chen MD”
  • “Find provider Dr. Maria Rodriguez”
  • “Look up provider John Smith with NPI [NPI]”
  • “Search for provider Dr. Jennifer Williams”
  • “Find provider Robert Anderson MD”
  • “Look up provider with name David Lee”
  • “Search for provider Dr. Lisa Brown”
  • “Find provider with NPI 9876543210”

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Financial Operations & Reporting

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Payment Transaction Analysis

  • “Show me payment transactions for patient [ID] and responsibility requests [ID], [ID]”
  • “Get detailed payment breakdown for patient Smith’s recent charges”
  • “List all transactions for patient [ID] responsibility requests”
  • “Show me refund history for patient Garcia”
  • “Review payment transactions for patient [ID] from last month”
  • “Get transaction details for patient Chen’s account”
  • “Show me all payments and adjustments for patient [ID]”
  • “List payment transactions for responsibility requests [ID], [ID], [ID]”
  • “Review transaction history for patient Williams”
  • “Show me payment methods used for patient [ID]“

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Financial Adjustments & Refunds

  • “Refund payment ledger [ID] for $100 via credit card - duplicate payment”
  • “Process cash refund for ledger [ID] amount $50 - overpayment”
  • “Refund check payment ledger [ID] for $75 - services cancelled”
  • “Process Smart Pay refund for ledger [ID] - billing error”
  • “Refund ACH payment ledger [ID] for $200 - insurance covered”
  • “Write off patient [ID] balance for requests [ID], [ID] - financial hardship”
  • “Process refund including fees for ledger [ID]”
  • “Write off $150 for patient [ID] - charity care adjustment”
  • “Refund partial amount $25 from ledger [ID]”
  • “Write off copay balance for patient [ID] - sliding fee discount”

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Communication & Workflow Management

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Patient Statements & Messages

  • “Show me patient statements config for email on 2024-10-31”
  • “Get patient statements sent on 2024-10-30”
  • “Show me text message statements config for today”
  • “Review patient statements sent yesterday”
  • “Get pre-visit text messages sent on 2024-10-31”
  • “Show me workflow config for workflow [ID] on 2024-10-31”
  • “Review text message delivery status for 2024-10-30”
  • “Get patient statement delivery report for last week”
  • “Show me pre-visit message workflow [ID] configuration”
  • “Review statement sending history for October 2024”

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Page Navigation

  • “Take me to encounter [ID] details”
  • “Navigate to import error [ID]”
  • “Show me reports for revenue analysis this month”
  • “Go to encounter [ID] billing summary”
  • “Navigate to patient [ID] account details”
  • “Take me to claim [ID] details”
  • “Show me reports for appointment scheduling patterns”
  • “Go to encounter [ID] for billing review”
  • “Navigate to error [ID] for resolution”
  • “Take me to reports for payment analysis”

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Support & Troubleshooting

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Problem Investigation

  • “Patient John Smith says they were double-charged - investigate their account”
  • “Claim for encounter [ID] was denied - show me the details”
  • “Why does patient Maria Garcia have a credit balance?”
  • “Patient Chen received a bill but says insurance should have paid - investigate”
  • “Encounter [ID] shows an error - what went wrong?”
  • “Patient Williams was charged twice for the same visit - review account”
  • “Why is encounter [ID] still showing as pending after 30 days?”
  • “Patient Anderson’s insurance claim was rejected - explain why”
  • “Investigate duplicate payments on patient Johnson’s account”
  • “Why does patient Garcia show a negative balance?”
  • “Review billing discrepancy for patient Smith’s October visits”
  • “Patient Chen says they already paid but still received a bill - investigate”

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Support Ticket Creation

  • “Create a support ticket for claim submission error on encounter [ID]”
  • “I need help with a complex insurance coordination issue for patient Garcia”
  • “Submit support ticket for system error when processing payments”
  • “Create ticket for encounter [ID] that won’t submit to insurance”
  • “Need technical support for bulk claim submission failure”
  • “Create support ticket for patient portal payment processing issue”
  • “Submit ticket for insurance eligibility verification problems”
  • “Need help with ERA posting errors for multiple encounters”
  • “Create support ticket for sliding fee calculation discrepancies”
  • “Submit ticket for appointment scheduling system integration issue”
  • “Need assistance with custom report generation problems”
  • “Create support ticket for patient statement delivery failures”
  • “Get available support ticket forms for my request”
  • “Show me fields for support ticket form [ID]“

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Guidance & Documentation

  • “Explain what CARC code 97 means for encounter [ID]”
  • “What steps should I take to resolve this denial?”
  • “How do I handle a patient disputing their balance?”
  • “What’s the process for correcting a claim submission error?”
  • “Explain the difference between encounter status and claim status”
  • “How do I know when to submit to secondary vs tertiary insurance?”
  • “What does ‘pending recon’ mean for an encounter?”
  • “How should I handle a patient requesting a payment plan?”
  • “What’s the proper way to process an insurance overpayment?”
  • “Explain when to use different procedure modifiers”
  • “How do I handle coordination of benefits issues?”
  • “What’s the best practice for following up on unpaid claims?”
  • “How do I set up sliding fee schedules for patients?”
  • “What’s the difference between copay and coinsurance?”