MACESS
Patient Cost Estimate
Healthy Discount
Quoting Benefits
Tools
100
Is the form used to track all inquiries received by a Health Net Customer.
SF or Service Form
100
Turn Around Time for CA/AZ
2 Business Days
100
If the member's plan states that Acupuncture and Chiropractic are not covered, we have to refer the caller to _______ for them to receive a 25% discount off the usual and customary fees from contracted acupuncturists, chiropractors and massage therapists.
"Choose Healthy"
100
What is the complete benefit disclaimer for HMO?
"As authorized by Medical Group"
100
Ram got his plan from his employer, he called Healthnet to check his benefit for office visit, what OMNI Jovenn should use to pull up his account?
OMNI 1
200
Opens any items that you have “to do”. Also known as an In-Box.
To Do List
200
What is missing?
Physician Information:
Physician's First Name:
Physician's Last Name:
__________________
Physician's Address:
City:
State:
Zip:
Provider Tax Id (Including the suffix):
200
_________ offers providers a free 30-day program and 25% off a premium program. Food and shipping not included.
"Jenny Craig"
200
What is the disclaimer for PPO?
"As provided by Healthnet contracted provider"
200
Joy would like to check the status of an appeal about the claim, what tool should she use to check the status?
MACESS
300
A service form must be created for each call
Create a Service Form
300
What is missing?
Member information
Subscriber Id:
Subscriber Name:
___________
Patient Name
300
________ offers three weight loss solutions: Weight Watchers Local Meeting Vouchers , Weight Watchers Online Subscription, and Weight Watchers Monthly Pass
Weigth Watchers
300
Jenny would like to check the accumulation of a member who has an HMO plan, what prompt should she use in ABS?
CLACCI
300
Jason purchased his plan from Covered California, he called Healthnet to check his benefit for CT scan, what OMNI Opal should use?
OMNI 2
400
Allows you to locate a particular document (claim image, SF, etc.) by doing one of several types of searches.
Open Document
400
Professional Services Only (CA/AZ/OR): Cost Estimates are available for the following services , which of the following does not belong?
-Office Visits
-Diagnostic Pathology and Laboratory Procedures
-Infertility Services
-Immunizations
-Orthopedic-Musculoskeletal Surgery
-Digestive System Endoscop
Infertility Services
400
What is the telephone number of "Choose Healthy"
1-877-335-2746
400
Aside from ifp.healthnetcalifornia.com, we can also use ABS to check if the cpt/hcpc code will need an authorization, what is the ABS prompt?
PALISINQ
400
If we would like to access the member's/provider's account on the website, what tool we should use?
Assume Identity or Support a User
500
Where you will track basic demographics of the inquiry. Use caution to ensure you have filled out each field completely
Contact Tab
500
Once patient cost estimate is completed it needs to be forwarded to________ using MACESS.
*PATIENT PAY ESTIMATE
500
Health Net members and their immediate family members (grandparents, parents, spouse, and children) may receive: • A free hearing screening. • A 25% retail discount off the purchase price of any Beltone hearing aids. • A free second-year warranty at participating Beltone Hearing Centers.
"Beltone"
500
HCPC Injectable Crosswalk is used to quote benefits for Jcodes, where can we find it?
Provier Library
500
ABS mean?
Automated Business Systems