ARI
Dental
Medical Equipment
Behavioral Health
Labs/XRays
100

The use of this company for ARI precertification depends on the customers state of Residence

EVICORE

100

This is defined as the prevention, diagnosis and treatment of a wide variety of conditions, disorders, and diseases affecting the teeth, gums and maxi facial (jaw, Face0 region of the body

Dentistry

100

These are considered Key Attributes of Consumable Medical Supplies

Are usually disposable in nature

Cannot with stand repeated use by more than one individual

Are Primarily and customarily use to serve a medical purpose

Generally are not useful to a person in the absence of illness or injury

100

This is defined as a persons condition with regard to their Psychological and emotional Well-being.

Mental Health

100

These services offer Health Care professionals beyond what they see and how they patient presents their symptoms. 

Laboratory Services

200

This is the One View Network Id for Evicore/Med Solutions.

What is NW355

200

These 7 are considered the different types of dentistry. 

General Dentistry

Endodontics

Oral Surgery

Orthodontics

Periodontics

Pedodontics 

Prosthodontics

200

These are examples of Consumable Medical Supplies.(Name 4)

Diabetic Testing Strips 

Colostomy Bags, Gauze, Medical Tapes, Cotton Balls, Antiseptics, Alcohol, Bandages,.


200

This is defined as any disorder other than one induced by alcohol or drug abuse, that impairs perception, memory, emotional equilibrium, thought or behavior, it could be genetic, Congenital, or acquired as a result of Physical, Psychological, chemical or social factors.

Mental illness

200

Health conditions not being seen at surface level, Not visually seeing Blood count or cholesterol levels, Blood and urine providing more evidence of diseases and can provider more definitive evidence a patient has conditions such as diabetes or hyperlipidemia.

Reasons to do conduct blood work

300

This is the network Id for Evicore in Facets.

NATMSI000001

300

Thinking of the structure of the mouth, there are 2 of these in every mouth.

Arches

300

This type of equipment is not disposable in nature and can withstand repeated use by more than one person.

Durable Medical Equipment


300

These are common MH/SA Health Care Professionals

Social workers, Psychologists, Psychiatrists, Counselors, Board Certified behavior Analyst, Behavioral Health Therapist, Pastoral Counselor

300

These CPT codes fall in the range of 8000

Lab CPT codes

400

These are different types of ARI. I am looking for 4 

MRI, MRA, CAT, PET scans

400

Again thinking of the structures of the mouth there are 4 of these and yes they can All be done the Same day!

Quadrants


400

Name some examples of Durable medical Equipment. DME. (looking for 4)


Crutches, Hospital Beds, Wheel Chairs, Respirators,

CPAP machines, Portable Oxygen, Insulin Pumps, Hearing Aids.

400

This is defined as one chemically dependent upon Drugs, Alcohol or both.

Substance Abuse.

400

These services fall with in the 70000 Range for CPT codes

Radiology Services including ARI

500

ARI scans can take place in the following places.

IP facility, OP Facility or office. 

500

Name the 2 Arches and the Four Quadrants of the mouth.

Upper Arch: Maxilla

Lower Arch: Mandible

Quadrants:

Upper Right

Upper Left

Lower Right

Lower Left

500

These are Artificial Substitutes worn on or attached to the outside of the body to replace a miss part.

External Prosthetic Appliances (EPA)

500

This was put into law in 2010, it requires that all health plans that offer MH/SA benefits to cover them oat the same level as the medical benefits. This means plans are not required to covered MH/SA however if it does a visit limit or dollar maximum can no longer be applied ot the MH/SA inpatient or outpatient care unless the same limit is in place for the medical benefits. This applies to ALL group health plans regardless of funding type.

The Mental Health Parity Act

500

This is a 2 part question and answer.

This includes both radiological and lab services. There will be times when the customer is billed with the same CPT code twice, with the different modifier for each. 

This includes charges made by the provider who interprets the technical component.

Technical Component




Professional Component

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