KMS
Does an Annual gyn require a referral for a PEBB Choice member?
What is NO?
The names of the ASO group that is a medical home based plan?
What are PEBB Choice?
The task page we use to log Medical Home changes.
May use member: 100685234-00
What is the PCP task page?
This is what a common deductible means.
May use member 100116545-00 (if needed)
What is the in and out of network deductible accumulate together (in the same bucket)?
Where a SAIF member would call to hear more information about health and wellness classes at a Providence facility.
What is the Providence Resource Line: 503-574-6595?
What do we need to confirm when validating a provider calling for a member?
What is the name, TIN and DOB?
1.This is what ProvChoice members must do to ensure they are receiving the best benefit available.
What is establish with a Medical Home and notify PHP of their selection?
What are CBC-Complete Blood Count, Chemical Profile, Cholesterol Screening, Fecal Blood for members over 50, Syphilis infection screening, Diabetes screening in adults and /or Urinalysis?
Whether or not Dr. Helen Henry under TIN 471463143 is part of a Medical Home.
May use member 100429152-04 if needed.
What is no, she is a PCP but not part of a Medical Home under that TIN.
This is how to log a CSI where member 100662678-00 has asked if her Annual Gyn exam has been used for this year... and it is still available.
What is the subject: LxAccums/Limits, Category: Annual Gyn, Summary: 2020, Click note: Annual Gyn Visit, Max - Individual, Used - Individual (or Remaining - Individual)?
Whether or not Kristen Schmiedeskamp is a covering provider for Breanne Brown in Tigard, OR 97224 and why or why not.
May use member 100687414-00 if needed.
What is yes, they are in the same network, practice under the same TIN and have the same specialty.
What task page do you document under if the member is asking if a referral is req?
If needed use mbr # 100569670-00
What is the UM History task page?
Whether or not Shannon Brigman in Newberg can be assigned as a Medical Home for member 100680734-00 and why or why not.
What is yes, because the PCP is credentialed with us as a Medical Home clinic.