CONTACT LOGS
CONTACT LOGS 2
CARRIERS
MISCELLANEOUS 1
AUTHORIZATION SITUATIONS
100

AUTH IS NOT REQUIRED

WHAT IS CONTACT LOG 10

100

EXAM IS DENIED.

WHAT IS CONTACT LOG 14?
100

CARRIERS THAT REQUIRE CLINICALS. 

WHAT ARE OUTLINED CARRIERS?

100

THE DAY WE REMOVE ACCOUNTS FROM THE SCHEDULE TO AVOID LAST MINUTE CANCELLATIONS.

WHAT IS DAY 2?

100

A CASE IS DENIED ON CARECORE.  YOU WILL NEED TO WAIT THIS LONG TO SUBMIT A CASE FOR THE SAME CPT UNDER THE SAME REFERRING DR AND RENDERING FACILITY.

WHAT IS 45 DAYS.

200

AUTH IS OBTAINED

WHAT IS CONTACT LOG 9


200

THIRD TIME REQUESTING CLINICALS.

WHAT IS CONTACT LOG 2B?

200

THE NEXT PORTAL TO CHECK IF A PATIENT WITH AETNA DOES NOT POPULATE ON CARECORE.

WHAT IS MEDSOLUTIONS?

200

IF YOU CONFIRM A PATIENT NEEDS A CT ABDOMEN AND PELVIS, BUT THE AUTH IS FOR A CT ABDOMEN, THIS MUST BE DONE. 

WHAT IS OBTAIN A NEW AUTHORIZATION?

200

A PATIENT IS SCHEDULED 5 DAYS FROM NOW, AND THE AUTHORIZATION EXPIRES TOMORROW.  RESCHEDULING THE PATIENT IS NOT AN OPTION. YOU SHOULD...

NOTATE THE ACCOUNT THAT A NEW AUTH WILL NEED TO BE OBTAINED AFTER IT EXPIRES.

300

FIRST TIME REQUESTING CLINICALS.

WHAT IS CONTACT LOG 2


300
CASE IS IN MEDICAL DIRECTOR REVIEW.

WHAT IS CONTACT LOG 5?

300

IF AN EMPIRE BCBS PLAN DOES NOT POPULATE ON AIM, YOUR NEXT STEP IS...

WHAT IS CALL THE BCBS HOMEPLAN?

300

YOU SEE AN XRAY IS NEEDED PRIOR TO INITIATING A CASE, BUT YOU SEE NO MENTION IN THE CLINICALS AND NONE IN THE PATIENT'S CHART. YOU SHOULD...

WHAT IS CALL THE REFERRING DOCTOR AND ASK IF THE PATIENT HAD ONE DONE

300

AN AUTH ON MEDSOLUTIONS  EXPIRED LAST WEEK AND THE PATIENT IS SCHEDULED IN A FEW DAYS. THERE IS NO CLINICAL INFORMATION IN THE PATIENT'S ACCOUNT AND YOU CAN'T REACH THE REFERRING MDO.  YOU COULD...

CALL MEDSOL AND ASK TO SPEAK TO A NURSE AND START A CASE.  TELL THE NURSE YOU WANT TO USE THE SAME INFO FROM THE LAST AUTHORIZATION THAT EXPIRED. 

400

SITE CHANGE NEEDS TO BE PERFORMED.

WHAT IS CONTACT LOG 8?

400

AUTH IS ON FILE FOR AN MRI BUT MAY NEED A DOWNCODE.

WHAT IS CONTACT LOG 8?

400

YOU MUST REMOVE THIS WHEN LOOKING UP CLINICAL CASE STATUS ON THE UHC PORTAL FOR OXFORD PLANS.

WHAT IS THE LAST 2 DIGITS OF THE MEMBER ID?

400

THIS DOCUMENT IS USED AS CLINICALS TO SUBMIT A CASE FOR A CT LUNG CANCER SCREENING.

 WHAT IS AN LDCT WORKSHEET?

400

A CASE IS DENIED ON CARECORE FOR CPT 70553 FOR A DIFFERENT FACILITY.  INSTEAD OF WAITING THE REQUIRED AMOUNT OF DAYS TO RESUBMIT, YOU CAN SUBMIT FOR OUR FACILITY WITH A DIFFERENT...

WHAT IS REFERRING DOCTOR

500

CASE IS DENIED, BUT DOCTOR WANTS THE PATIENT TO REMAIN ON THE SCHEDULE, BC THEY ARE DOING A PEER TO PEER.

CONTACT TYPE 7

500

YOU INITIATED A CASE, BUT IT NEEDS CLINICALS, SO YOU CONTACT THE MDO TO REQUEST CLINICALS FOR THE FIRST TIME.

WHAT IS CONTACT LOG 2?

500

YOU MUST FAX THIS IN WITH THE AUTH FORM FOR AETNA BETTER HEALTH TO INITIATE A CASE.

WHAT IS THE CLINICALS. 

500

YOU SEE ON CARECORE THAT ADD'L INFO IS REQUIRED FOR A PENDING CASE.  YOUR NEXT STEPS SHOULD BE..

WHAT IS READ THE LETTER SENT TO THE PHYSICIAN AND SEE WHAT IS NEEDED. THEN CONTACT THE MDO TO REQUEST THE INFORMATION.

500

A CASE IS DENIED ON AIM.  YOU WILL NEED TO WAIT THIS LONG TO SUBMIT A CASE FOR THE SAME CPT UNDER THE SAME REFERRING DR AND RENDERING FACILITY.

WHAT IS 0 DAYS.
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