IYK, YK
"Aetna Medicare members have the right to request an expedited appeal should they feel that the standard 30-day turnaround time could jeopardize their health."
Expedited appeal Disclaimer.
When Star Central fails ...I can be your resource to file ana expedited appeal. What am I and where can you find me?
Expedited appeal quickbase found in wikitools.
It takes this amount of time to receive a decision for an expedited appeal.
72 hours
You look here to find paper letters and email sent to the member.
Communication tab.
I need clarity on a prior authorization status...who can I can?
The Precertification Department
RXBIN and RXPCN can be found here
1. Policy name
2. Details
I am your document viewers...
IOP and ECHS
As a customer service rep you use me to file an expedited appeal.
Star Central
I can be found on the service line in MedCompass... i am Five Numbers wink wink;)
CPT/Procedure code
True/False ..It is mandatory to offer survey on a call where the caller does not have a plan with us.
False
TAT for an expedited appeal
72 hours.
Best system to check Dental providers network participation.
Rumba
You have _____ from the date of our written denial notice to ask us for an appeal.
65 days
Follow these steps in GPS to get me to referrals
1. Menu navigation
2.Clinical
3. Referrals
Z status in evicore means...
Partially approved
Hub that holds all systems and other resources.
NextGen Wiki
Where to go to send a provider's directory.
Click...
1.Create Service request
2.Provider directory -request
3.Select next verify member's address, advise tat and finish.
Who can file an Expedited Appeal?
The member, or anyone filing on behalf of the member, can file an appeal
I house important alerts on the member's account. What icon am I.
The bell.
Name Two systems to locate a broker's NPN number
1. Market Prominence
2.HRP
Member can go here to find the customer service number for their plan.
Back of the member ID card.
Select me in GPS to stop sending paper EOB. Outline steps
1.Menu navigation
2.Member
3.Communication preferences
4.Suppress EOB Paper Statements
Only I can request a peer-to-peer review by doing what?
Only the provider can request a peer-to-peer review by calling the phone number provided on the denial letter.
1.Click on policy name
2.View Medicare attributes
3. Part D late Enrollment Penalty.
I generally do not have an expiration date...what document am I.
Power of Attorney (POA)