Systems
The system in which we can order an ID card for a member
COWA
True or False: If the birth parent of a newborn was assigned to Health Share of Oregon at the time of labor and delivery, the newborn is enrolled with Health Share of Oregon effective their date of birth to the same plans the birth parent was on at the time of labor and delivery
True
True or False: An adult member can provide verbal authorization to another adult caller
True
HSO stands for:
Health Share of Oregon
CCO stands for:
Coordinated Care Organization
The system in which we document all of our calls
CIM
The number of Behavioral Health plans available to HSO members
One
True of False: We can discuss mental health appointments with a parent of a 16 year old without verbal authorization
False
OHP stands for:
Oregon Health Plan
Medicaid covers these three things
Physical (Medical), Oral (Dental), Behavioral Health
The system in which we can adjust the effective date
COWA
Name two Dental Plans available to HSO members
Advantage, CareOregon, Kaiser, ODS (Oregon Dental Service), Willamette
The number of pieces of information we must verify before disclosing PHI
Three
PHI stands for:
Personal Health Information
The primary payer between Medicare and Medicaid
Medicare
The system in which we can find the Branch ID and phone number
MMIS
Name two Physical (medical) Health Plans available to HSO members
CareOregon, OHSU Health, Providence Health Assurance Plan, Kaiser
List four pieces of information that we can use to verify HIPAA
Full name, DOB, Address, Member ID, Last 4 digits of SSN
HRS stands for:
Health Related Services
The tab in CIM that shows the Case ID
Member Data
The system in which we select a disposition
Max (phone system)
The plan type when a member has only dental coverage
CCOF
The name of the document a member can complete to give authorization to a third party caller
ROI - Release of Information
NEMT stands for:
Non-Emergent Medical Transportation
The three counties HSO covers
Clackamas, Multnomah and Washington