System/Navigations
Locate dental history in this section of skygen
Tooth history
This article speaks to claim denial for premium not being paid
Date of Service Exceeds the Member's Paid Through Date Denial
These lens are known as no line bifocal
Progressive lens
Coinsurance levels/Deductible amounts are the same for in- and out-of-network plan designs.
Passive PPO
How many codes and members can we assist with per interactions
10 codes and 5 members
I can view check or card details sent to provider in this tool
VPAY
This article shows the example to complete a RADAR ticket
Dental/Vision Privacy Incident Awareness
Alternate benefit for Composite/Resin
Amalgam filling
These plans require Claw01 in portal admin
Colonial individual worksite plans
Address needed to send dental claims via mails
PO Box 80139, Baton Rouge, LA, 70898
This application shows your schedule, calls, audits
Verint
This article speaks to policies and benefits are not payable to replace a tooth that was extracted prior to coverage
Missing Tooth Clause.
A PreD expires after how many days
90days
Implant bodies frequency is
One per lifetime
T/F verbally collect information is acceptable over the phone from provider
False
This tab allows you to see all your follow up and complete follow ups
Provider Follow up
This document provides escalation process and TAT
Escalation Process
Box 36and Box 37are signed or stamped: Signature on File
Who gets paid
Provider
These numbers are given to luxottica stores for filing eyemed claims
Cole conversion numbers
Timeframe to send claims from DOS
This tool shows the TAX/NPI, Member id, member id once call comes in
AWS
This article guides DVBAs on HIPPA verification steps for members and providers.
Verification Quick Reference Guide
Navigate here to view vision eligibility for members
Eligibility-----Accums
These two plan both use Dental mod and legacy prior to dental mod on claim processing guide
Group and State plans
This type of claim is suggested and not mandatory
Pre D