proceed with sending the case to the IRO
Houston, under Carrier/Set up form” tab /DIV Implementation and anything mentioning APPEALs/attachments
what is Always Read and follow the word doc on Tips for pulling the OCEP Policies before proceeding
On Day 2, If the IRO is URGENT, Email the AM for a 2nd attempt and notate the email with your 2nd attempt, copy in Jen - send the case to the IRO . Indicate on the form that it is WITH TRUST - Save the email in the M drive. Jen will save a copy on her end for billing purposes when the IRO comes around to collect payment
Make the first attempt to email the AM.
On Day 3 (Standard requests only), Email the AM for a 3rd and final attempt and Copy in Jen. - Send the case to the IRO. - Indicate on the form that it is WITH TRUST. - Save the email in the M drive. Jen will save a copy on her end for billing purposes when the IRO comes around to collect payment.
On Day 2, Email the AM for a 2nd attempt and notate the email with your 2nd attempt
On Day 2, Email the AM for a 2nd attempt and notate the email with your 2nd attempt
Add a case communication into C360, that a copy of the letter was mailed to the member and faxed to the Dr for patient signature.
On Day 3, Email the AM for a 3rd and final attempt, send mildly threatening notice that client will need to decision the IRO if signed form is not received . - Place the IRO email in the folder with notation of 3rd attempt. If AM replies with confirmation for client to process, send the appeal to them. Document the case in C360. File the IRO in the M drive
On Day 3, Email the AM for a 3rd and final attempt, send mildly threatening notice that client will need to decision the IRO if SPD is not received . Place the IRO email in the folder with notation of 3rd attempt. If AM replies with confirmation for client to process, send the appeal to them. Document the case in C360. File the IRO in the M drive
Save the Case in WAITING until one of the above happens
(form sent or located)