PROVIDERnet
Department that administrates practitioners and providers within PBC
What is Provider Relations?
You need to advise the provider to do this for vision eligibility.
What is submitting a pred?
Type of MSDPR coverage that has no basic dollar limit
What is emergency only?
FNHA members will use this as their ID number.
What is a status number?
What is 77030?
Site that you direct providers to in order for them to register for PROVIDERnet
What is our external website (www.pac.bluecross.ca)?
Covers eye exams for individuals under 19 and over 64
Who is MSP?
Type of dentures that will never be paid over limit
What is a cast denture?
Annual limit for FNHA dental
What is unlimited?
Dollar maximum for MSDPR Hearing instruments?
What is $2000 per ear?
Pharmacy provider account type that can update banking and contact info
What is a Primary Administrator?
Needs a change of +/- 0.50 in one field (sphere, cylinder, prism, reading add) to be done
What is a lens replacement?
This must be confirmed with the provider for MDSPR clients.
What is month-to-month/active coverage?
How a dental provider would submit orthodontic claims for an FNHA client over age 18
what is manual submission?
MCFD clients are referred to as...
What is child in care?
Health and vision provider account type that can view only resources, submit/reverse claims and view pre-d's only
What is Full Edit?
This group needs the sphere and cylinder to add up to 6 or higher in at least 1 eye for high index
MSDPR DATs are assigned to...
What is MHSD DAT?
How many levels of appeal are there for providers submitted for FNHA clients?
What is 2?
Contains information about claims that have not yet reached ACES for adjudication?
What is Transaction History Log?
The only people who can request a PROVIDERnet password reset
What are Primary Administrators or Practitioners?
Not eligible at any time even if providers try to argue that they are trifocals
What are progressive lenses?
Ministry only considers funding orthodontics if they meet this condition.
What is severe skeletal dysplasia?
Optical provider that can perform eye exams but not dispense glasses or contacts
What is an ophthalmologist?
Only a TL or manager can edit this type of note
What is PAP note?