U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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(HIPAA) Medicare Part D Revenue Operations Manual (ROM) Third Party Internal Controls Patient Registration Third Party Billing National Business Office Coordinator’s Meeting Minutes Accounts Receivable Management Tools Unified Financial Management System (UFMS) Business Office Solutions Training ListServ Questions or Comments. Please contact the Site Manager

Revenue Operations Manual (ROM)

Part 2 - Patient Registration

Click on any Chapter Title to download, view, or print individual chapters and appendices.

Chapter 1. Overview of Patient Registration [PDF-75KB]

  • 1.1 About the Revenue Operations Manual
  • 1.2 About Patient Registration
  • 1.3 IHS National Registration Policy and Procedures
  • 1.4 Customer Service
  • 1.5 Telephone Etiquette
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Chapter 2. Patient Eligibility, Rights & Grievances [PDF-72KB]

  • 2.1 Patient Eligibility Criteria
  • 2.2 Other Eligible Categories of Patients
  • 2.3 Determination of the Degree of Indian or Alaska Native Blood
  • 2.4 Patient Rights and Grievances
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Chapter 3. Direct Care and Contract Health Services [PDF-59KB]

  • 3.1 Direct Care Services
  • 3.2 Contract Health Services (CHS)
  • 3.3 CHS Medical Priority Criteria
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Chapter 4. Registration, Discharge, and Transfer [PDF-139KB]

  • 4.1 About the Medical Record
  • 4.2 Temporary Medical Record Number Assignments
  • 4.3 Master Patient Index (MPI)
  • 4.4 Name/Birth Date Change Requests
  • 4.5 New Patient Registration
  • 4.6 Established Patient Registration
  • 4.7 Non-Beneficiary Registration
  • 4.8 Commissioned Officers and Dependents Registration
  • 4.9 Scheduled Patient Registration
  • 4.10 Unscheduled Walk-in Registration
  • 4.11 Inpatient Admissions Registration
  • 4.12 Scheduled Inpatient Admission Procedure (Adult, Pediatric)
  • 4.13 Newborn Admission Procedure
  • 4.14 Observation Bed Admission Procedure
  • 4.15 Discharge and Transfer Processes
  • 4.16 Non-Beneficiary Exit and Collection Process
  • 4.17 Reconciliation of RPMS Admission/Discharge/Transfer Statistics
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Chapter 5. Third Party Coverage [PDF-208KB]

  • 5.1 About Medicaid and Medicare
  • 5.2 Medicaid
  • 5.3 Medicare
  • 5.4 Medicare Part A
  • 5.5 Medicare Part B
  • 5.6 Medicare/Medicaid Dual Eligibles
  • 5.7 Medicare Advantage, Part C
  • 5.8 Medicare Managed Care
  • 5.9 Medicare Prescription Drug Plan (Part D)
  • 5.10 Railroad Retirement
  • 5.11 Private Insurance
  • 5.12 Managed Care
  • 5.13 Dental Insurance
  • 5.14 Pharmacy
  • 5.15 CHAMPUS/TRICARE
  • 5.16 Workman's (Worker's) Compensation
  • 5.17 Third Party Liability
  • 5.18 Grant Programs
  • 5.19 Medicare Secondary Payer (MSP)
  • 5.20 Tribal Self Insurance
  • 5.21 Verifying Third Party Insurance Coverage
  • 5.22 Prior Authorization Process
  • 5.23 Patient Referral to the Benefit Coordinator
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Chapter 6. Scheduling Appointments [PDF-34KB]

  • 6.1 About Scheduling Appointments
  • 6.2 Appointment Scheduling Process
  • 6.3 Exceptions to the Standard Scheduling Process
  • 6.4 Preventing "Did Not Keep Appointments" (DNKA)
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Chapter 7. Benefit Coordinator [PDF-83KB]

  • 7.1 About the Benefit Coordinator
  • 7.2 Outpatient Identification and Verification Process
  • 7.3 Eligibility Verification
  • 7.4 Inpatient Identification and Verification Process
  • 7.5 Medicaid Eligibility and Application
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Appendixes

  1. Application for Medical Services (Form 58, Adult) [PDF-53KB]
  2. Indian Blood Quantum Formula [XLS-16KB]
  3. Name Change/Birth Date Correction Request [PDF-20KB]
  4. Admission Call-In/Check-Off List [PDF-39KB]
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