Name That Portal
Which portal is commonly used for BCBS SC authorizations?
What is CoHere?
The portal says NAR, but the rep says prior auth is required. What should you always obtain?
What is a call reference number?
What is required for a sinus to meet Aetna CT criteria?
What is >3 mm mucosal thickening and an LM score?
Where is the “No Revision List” for BSD located?
What is the Auth Resource Bank on SharePoint?
Are you able to submit for septoplasty with UnitedHealthcare Medicare Advantage?
What is yes?
Which portal/IVR system is commonly considered one of the most challenging to submit authorizations through?
What is Horizon BCBS NJ?
You discover the referral only supports ear procedures, but the office wants to perform BSD. What diagnosis may need to be added?
What is J32.9 (Chronic Sinusitis)?
Can you submit an auth to UnitedHealthcare (UHC) for a completely opacified sinus without an LM score?
What is yes?
Who should be contacted when an OV or CT is not listed on the CAT?
Who is the RAM?
Can you code SSB for Premera?
What is no?
Which portal requires you to change the state to access the correct insurance payer?
What is Availity?
A patient’s DOS is tomorrow and the authorization is still pending. What is the best escalation step?
What is request escalation?
Does an aplastic sinus meet criteria to submit an auth?
What is no?
How many attempts should be made to correct an effective date issue before escalating to your regional lead or manager?
What is 3 attempts?
Which payor commonly requires Propel to be submitted with 4 units?
What is BCBS?
Which portal is commonly used for submitting and managing prior authorizations for many Anthem plans?
What is Carelon?
What must often be included on Tricare Prime (East) referrals for planned procedures?
What are all CPT codes?
Which three insurance plans commonly require an external CT read for review?
What are BCBS LA, Providence, and Regence?
What internal system is commonly used to review CT reports, appointment notes, and uploaded approvals?
What is AMD & EHR?
What CPT code is commonly associated with image-guided sinus surgery?
What is 61782?
Which portal is VIP only and not available for all provider within BF?
What is BCBS CA?
The authorization was approved under the wrong TIN/address. What should be done before DOS?
What is correcting the provider/TIN information with the payor?
When a nasal endoscopy notes “resection of a middle turbinate,” what procedure is this referring to?
What is a Concha Bullosa Resection?
What CAT color is commonly used to indicate a valid approval is already on file?
What is green?
When propel needs auth, who do you email?
What is Nixon?