Predict Errors
Transaction Types
NDB
Provider Basics
Random
100

What SOP must be used to resolve any pre-defined business rules?

S1059 

NDB PREDiCT - Provider Error Detection and Correction Tool

100

An agent is informed through a request that an existing provider needs to be added to another group other than what he/she is already associated with. This change triggers what kind of maintenance?

Demographic/Tax ID Add

100

Once a user enters the MPIN, TIN, and name of provider and hit enter, which screen displays in NDB?

Selection Screen

100

Par providers are credentialed through whom?

NCC

100

Where should you save all important documents, OneNote, and other materials you'd like to potentially share later with someone?

Network/OneDrive

200

According to S1059 business rule 038, what should be done if the CORP name and PTI name DO NOT match exactly?

Proceed to Step 5 and check the I/A/Z for every Bill/Combo to ensure the DBA name field is populated with the PTI name

200

Dr. Deflores has notified us that she will be joining ABC Medical Group and would like to be contracted with their Medical Group Agreement (MGA) Contract. What kind of transaction request will this be in PhyCon?

Contractual/Practitioner Add to Group

200

Which field is used for navigating within the sub-system menu?

CATOGERY

200

What ten digit number is issued to a provider by Centers for Medicare and Medicaid Services (CMS)

NPI

200

What type of address can never be under a BILL in NDB on the selection screen?

COMBO

300

Refer to the NDB Predict - Provider Error Detection and Correction Tool S1059 SOP for Business Rule 052 - License Number Validation. If the state license number is not found on the Source of Truth (SOT) what do you do?

Check the CNR box in Predict for rule

300

A request came through for the DLA to add a CLIA number to a provider. What type of transaction would this be?

Demographic/Other

300

What type of address must a user be in when navigating to the I/A/M?

PLSV or COMBO

300

What is the difference between a P-Type and an O-Type Record?

P is Individual

O is for an Organization

300

Before submitting a GD in PhyCon you must clear all of these?

Flags

400

According to the NDB Predict User Guide J4144, how do you resolve errors?

-Use outside resources such as NPI Registry or USPS websites

-Additional research of same/other provider within NDB

-Source of Truth (within the current PhyCon Transaction)

-PhyCon History/PR or GD transactions within last 60 days

400

An MPIN needs to be reactivated in NDB. What type of request does this trigger in PhyCon and what type of transaction has it shown up as in PhyCon recently?

Demographic/Non Par Practitioner Add

400

What is the correct format for a wild card search with a last name of only 4 characters?

4 characters and a space, then include an asterisk

400

What can have up to nine digits and is assigned to the provider by UHC?

MPIN

400

Which screens are Address specific to an MPIN/TIN

A, L, I/A/M

500

What screen does an agent need to visit if Business Rule 027: PCP ID/UHCID Alignment populates after running Predict?

IWZ

500

What is the difference between TAX ID and TIN in reference to the Loading Transaction Definition Guide?

TAX ID: Demographic

TIN: Contractual

500

What five categories do Non-Del users visit that are in an area other than Z?

I/H/A

I/F/C

I/A/M

I/D/C

I/T/C

500

What are the four reasons of why a Tax ID change would occur?

A provider decides to incorporate.

A provider joins a group of physicians.

Multiple providers decide to form a new group.

A provider decides to go into practice with another individual provider.

500

If you do not touch NDB at all, what does the agent place in the Predict ID field in PhyCon?

88

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