Insurance Verification
For UHC, do we go based off the plan name or claims address?
Claims Address
No, must have a cancer diagnosis.
When working on a brand new account, what is the 1st step to complete before verifying eligibility/benefits?
Change referral status to Pending Review/Coverage Verification Needed
This team submitted SARs for CCS patients.
Who are financial counselors?
This executive serves as the CEO of City of Hope.
Who is Robert Stone?
What is the Blue card phone number?
(800) 676-2583
What is the newest Covered California health plan that CLN and NMC are now contracted with?
Health Net Covered CA Ambetter Plan
Could you please clarify which visit types the NPS FCS team clears that are considered non-billable?
Genetic Counseling visits scheduled with a non-MD
Which CPT code should we use when submitting for a hospital follow up?
99215
Which Rad ONC location is now under NMC Hospital License?
Arcadia Rad ONC
This coverage is indicated when a patient's medi-cal aid code is "0P."
Breast and Cervical Cancer Treatment Program (BCCTP) Federal Program
Which excel sheet does managed care utilize for important information?
Red Flag Matrix
What do we need to find the Medicare MBI number & where can we find it?
SSN and Noridian or cortex
Do we require an authorization & LOA for SNF patients?
No
What is the maximum duration for COBRA coverage?
18 months & may be extended to 36 months under certain circumstances.
SoCal Meritain patients can utilize this network to be seen at City of Hop
What is Aetna?
City of Hope recently obtained a contract with this IPA/MG effective 01/15/25.
What is Preferred IPA.
This action should be taken whenever a patient is redirected between NMC and CLN to ensure the referral status is updated appropriately.
What is changing the referral status back to pending?
How many places do you need to enter the authorization on the referral shell?
Two places
What are the 4 City of Hope's Values and Behaviors?
Trailblazing, Compassion, Inclusion, Integrity
Brand New Day joined this sister company and changed its name to this, effective January 1, 2025
What is Central Health Medicare Plan?
What is a blanket LOA?
LOA that covers for that specific MG
How should a second opinion referral shell be authorization?
Approved - 2nd opinion consult
Are we still accepting OPN patients?
No, we must redirect the patients back in-network.
In this year, City of Hope acquired Cancer Treatment Centers of America (CTCA).
What is 2022?