Request Profiles
Access to Care Standards
Acronyms
Care Radius
Production Dashboard
100

Evalauate and Treat

What is P1?

100

Processed within 24hrs, STAT, today.

What is emergent?

100

MTF

What is Military Treatment Facility?

100

Authorization Main, Member Snapshot, Correspondence, Intake are all located in this tab.

What is General Information?

100

Internal list for limitations, exclusions, verification of demographics.

What is the Provider List?

200

Evaluate Only

What is P3?

200

Processed with normal timeframes.

What is Routine?


200

EDI

What is electronic data interface?

200

The diagnosis code is verified (specific) using this sub tab. 

What is Authorization Main?

200

Sends to another team for processing if for testing, labs, procedures (and have not been trained). 

What is Route Auth?

300

Specialty Referral Extension

What is P4?

300

Request received AFTER services provided to patient

What is retro/retrospective?

300

ADSM/ADFM

What is Active Duty Service Member and Active Duty Family Member?

300

Verification of the "subscriber" or "dependent's" demographics. 

What is Member Snapshot?

300

Work Goal, Queue, Reference Number, and Disposition are found here.

What is the Assignment Task Log?

400

Requested Specialty: Urgent Care

What is P45?

400

Processed within 72hrs, ASAP

What is urgent?

400

PCM

What is primary care manager?

400

Search the "servicing provider" either  "named" provider or radius search.

What is the services tab?

400

Pends a case when the agent needs to ask a question. 

What is Pause?

500
Pregnancy, Z33.1, OBGYN

What is P126?

500

Request received before services are provided

What is prospective (future)?
500

WARF

What is Web Authorization Request Form?

500

Select checkbox when placed on 100% audit after training. 

What is Correspondence?

500

Assigns a case to another team if the request indicates IOP, SOT, PHP, etc.

What is disposition (inpatient)?

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