Department Quesiton
What tool should you check to identify potential duplicate MPINs for a provider?
Provider Console / OPERA AI
If outreach was made for information, but no response was received and the file must be placed into a 505 status, what should the 253 date be?
The 253 date should be today's date, which is the same date the 505 status is applied.
What fields must be completed in the Information Request section of the Education PSV Letter?
The following fields must be completed:
Name the advocate on our team who recently celebrated 20 years of service with UHC.
Brian
Why are thorough NDB notes critical during the credentialing process?
NDB is often the primary source of information for other departments that do not have access to Salesforce Lightning, so detailed notes help ensure accurate communication about a provider's credentialing status.
What date should you use to ensure the 253 code in NDB is accurate and aligned with Salesforce Lightning?
The Complete Application Received Date.
In NDB on the ISZ screen, what expiration date should be entered for an MD or DO with a lifetime board certification?
12/31/2999
Which team member earned the Employee of the Month recognition in August?
Abigail
What are 3 states that accept the CDR credential as a valid license for nutritionists?
Arizona, California, Colorado, Michigan, New Jersey, Virginia, and Washington.
What should you do with the 253 code in NDB and the Complete Application Received Date in Salesforce Lightning when a file requires outreach for missing information?
Both the 253 code in NDB and the Complete Application Received Date in Salesforce Lightning should be removed until the requested information is received and the file is complete.
What code signifies that all required information has been received and the credentialing file is ready for review and determination?
253 code
Which advocate is the only team member on the huddle agenda whose task list does not include recredentialing work?
Zannetta
When working an INI, if a provider's work history contains gaps or does not extend back five years, where can you look to find additional employment history?
Review the provider's work gap explanations, Curriculum Vitae (CV), and dates of completed education. You can also check:
A Florida (all-products) credentialing request required outreach for a DEA and Medicaid ID. The DEA was received today, but the provider does not yet have a Medicaid ID. What is the correct 253 date?
The file should be split, and the 253 date would be today's date for the 501 file.
If using the "Copy Source" button on an element, what should you do before marking the item as clean?
Verify that the source link is valid and correct before marking the item as clean.
Who is the next team member to celebrate a birthday?
Diamon (12/26)
When processing a multi-state credentialing file that includes KY EI/MR/C&S and PA EI and all requirements are clean except for the Kentucky Medicaid ID, how should the credentialing cycle be closed?
The file should be split:
What does the 253 date represent in the credentialing process?
The 253 date represents the date the application becomes complete and ready for a credentialing determination.
When is Board Certification verification required for NPs and PAs?
Board Certification is only verified for NPs and PAs when education cannot be verified by another method and the provider reports being board certified. It is not required on recredentialing cycles.
Daily Double!
According to our October edition of the Los Angeles Times, what special day is celebrated on October 21?
Back to the Future Day