Auth
What is the risk level to the following question:
What are the hours of operation of the call center?
What is: No Risk
What is the expense code for Psychologist?
What is: PSY00
In Sunbot, what code allows you to simultaneously retrieve coverage details for codes OPT00 + OPT01 + LEN00 + LEN05?
What is: VIS99
Name the expense code payable even when the receipt does not indicate that the services were paid for
What is: AMB00
Who is the SLF nursing care partner?
What is: Bayshore
What counts for 2 correct answers in Member deeper Auth?
What is: Sin #
How long is a dr's referral valid from the date it was issued?
What is: 12 months
Are the following items under eligible or ineligible expenses? Accessories, block fee or annual fee, visual aids and warranty services
What is: Ineligible Expenses
In which province is SLF the first payer for claims resulting from a motor vehicle accident AND for claims for victims of a crime?
What is: Manitoba
What is the R&C for foot care from a nurse (RNA00, RNA02)?
What is: $65 per visit (R&C amount is per visit or treatment; regardless of the duration of the visit)
What disclosure of information is as specific as the caller's level of knowledge?
What is: Implied Consent
What is the condition applicable to all/any providers you must advise a caller during a coverage call?
What is: The provider must be registered in the province where the treatment is being received.
How old do you have to be for the RAMQ to pay 250$ of your glasses and/or contact lenses purchase?
What is: 18 and under (only in Quebec)
What action must you take in the event there is no result in the health care facility excel document after RTS is unavailable?
What is: send the F9 template: CCC Tier 3 Inquiries (Hospital).
Where in seibel will you locate a decision on nursing questionnaire?
What is: Claimant Special Instruction (CSI)
What is the last deeper authentication question we can ask a member (as a last resort)?
What is: Other Sun Life products
Which system allows you to confirm the provider and/or facility's eligibility?
What is: Spector
What is the R&C for eye drops dispensed by an optometrist and/or ophtalmologist when there is no breakdown of charges on the receipt?
What is: R&C of $40 in a doctor's office
Which province has a particular condition under expense code REH02?
What is: Quebec
The facility must be a private center offering residential treatment, and if it's in Quebec, it must be licensed by the government.
In Labrador, nurses working for the Grenfell Association are permitted to do what?
What is: Prescribe medications due to the unavailability of physicians in outlying areas.
What critical information can only be confirmed to the member based on their knowledge?
What is: Banking information
Name at least one type of provider who can submit claims on the provider portal (direct billing)?
What is:
Acupuncturist
Chiropractor / Chiropractic x-ray
Massage Therapist
Naturopath
Optometrist
Physiotherapist
What are the 2 package maximum types based on: Fixed vision period from first purchase date?
What are:
Max type G
Max type J
What are the email address and subject line to submit Homewood Health Centre Estimates?
What are:
Email: HIMS.HDEAST@sunlife.com
Subject Line: Homewood Health Centre (case #)
Nurse Practitioner (NP) is equivalent to a Registered Nurse (RN) in which 3 provinces?
What are: Ontario, Quebec, and Saskatchewan