Benefits
This benefit has no out of network benefit and will always be in network
What is Emergency services
This is needed to validate the member
MEMBER ID, Name, DOB
with this app, we can pull ced, cpf and
CORKBOARD
This is the disclaimer that we normally say for the accumulators
I should also inform you that the dollars amount and the visits accrued are subjected to change based on claims processed at the time of this call
The member has an OAP IN, this means
What is the member has no out of network benefit
in this tool you can find the member account has been updated and what function key would we press to see it
When this service has been confirmed, you can provide office, pre&post natal and inpatient hospital and what service and benefit is this
pregnancy and maternity
To read the correct benefits for surgery where would you read
place of service, office, facility and professional
in CED what is the function on the member account that we press to see other insurance
press the F9 key
In cpf where do we find that the provider is either a specialist or PCP and where would we go to see if they are contracted
what is summary page and network relations list
This benefit is used for skilled nurse facility and sub acute
What is Other Inpatient facility services
The network id shows that the provider is contracted with ash and that the zip code is 90210, what would be the network id for ash and is MNR required
What is NW360, NW353 and yes
on the eligibility tab where would we know if the account is either an alliance or payer/third party
on the eligibility & claim system / alerts
MNR is required after the 5th visit, can this requirement be different and how
BA says otherwise, and SALT will state if the service should be through ash or not
This is needed to pass HIPAA
What is TIN, provider name/office/facility name, member id, name and DOB