Authorizations
This department reviews medical necessity for authorizations.
What is Utilization management?
Standard Operating Procedure
What is a SOP?
This is submitted by a provider after services have been provided.
What is a claim?
This skill is important when handling upset providers.
What is empathy?
When a provider has to call back about the same issue within a three day period.
What is first contact? FC
What is an appeal?
Aside from documentation, this should be done for every call.
What is digital education?
This document explains how a claim was processed and or paid.
What is an EOB?
This section of the uhcprovider.com portal is where the EOB is emailed to the provider.
What is the document library?