UHC-ID DIV's
UHC-ID's get loaded to what?
All billing and combo addresses
According to the Taxonomy grid, what is the Spec code for Sports Medicine?
296
What kind of addresses can be a primary?
Combo and PLSV
When reactivating a TIN, what else needs to be reactivated?
BSAR relationships, UHC-ID DIV's and all addresses tied to that TIN.
What should you use to check your work BEFORE submitting your GD to the SharePoint or completing it?
Quality Check-list and predict
How do you determine if a TIN is PAR?
Follow S4151 How to determine if TIN is PAR section
What is the cancel date called for a DEA or license number?
Expiration date
What address types get handicap indicator updates?
PLSV and Combo
When adding a new provider and a new Master TAX ID, what do you need to before working on the instructions?
Add legal owner of the TIN
Is a comment always required on a closed GD?
No
When do you Timeline a DIV?
When changing a bill/combo address to a new bill/combo address
When adding a Specialty, do you need to check if it needs to be credentialed?
Yes
How do you know what Billing/Combo address a PLSV is linked to?
PLSV will be loaded under the Bill or Combo address and the BAID number on the address details screen will be the billing/combo address id.
What is the correct way to look up your provider in NDB?
Look up by BOTH the MPIN and TIN.
How do you determine if the provider is delegated?
I-D-C screen and the PLMI
Does the U screen use the same cancel reason codes as the main NDB?
No, always use the cancel code job aid.
A practitioner can have more than one Medicaid ID's
Close
You get a GD to change the legal owner group name or a TAX ID. What will you do if the MPIN for the new legal owner has already been created in the system?
Submit a Q screen request. This would be required to update the legal owner if an MPIN for the new legal owner has already been created in the system.
What is the difference between timeline and change mode?
Timeline requires both effective/cancel dates and tracks the changes. Changes only get the cancel dates and doesn't track the changes.
When is a retrigger needed?
A PLSV address is being added to a BILL with existing UHCIDs, and the new PLSV is not the primary address, but an additional address.
You get a request to term a NPI due to a Quality of Care Termination. What cancel code do you use?
60
What do you do if the address on the request is active in NDB but with the wrong address type?
Follow the IF/THEN chart and replicate it if it tells you to
Can you term a TAX ID if other providers are attached to it?
If there are no other active requests found in Phycon, no you would close the request.
What do you do if you get a GD and it looks like the work is already done?
Double check all the work and submit to close