Network Status 1
Agent says "This provider is participating." This type of benefit should be collected.
What is in network?
This is another term for non-participating.
What is OON? (or Out of network?)
Which payor will have network status prefilled as INN?
Who is Blue Cross Blue Shield?
A doctor or practice that agrees to accept a discounted rate for covered services.
What is INN or participating?
This is the scenario in which both in and out of network benefits are collected.
What is network status is unknown and the plan has out of network benefits?
Accredo is in network but the address is different from what we have on the platform. What will input for network status?
What is in network different address?
The agent voluntarily provides the network status of the provider prior to being asked. This information cannot be taken since it was provided before being prompted. True or False?
What is False?
If the provider is out of network and there are no out of network benefits what do you do next?
What is Gracefully Exit?
What is the pushback if the agent states the plan has no out of state benefits?
What is "If the services are rendered in-state, can I collect INN benefits?"
If the provider status is unknown and the member does not have out of network benefits do you gracefully exit?
What is no, we attempt to collect INN benefits first.