Do
These are considered Non-individual providers
What are hospitals, other facilities or groups
This The branch of medicine concerned with the diagnosis and treatment of health problems in people of any gender or age.
What is Family Practice
What are the common types of rooms
What are Private, Semi-Private and Ward
This is used to search by Identification Numbers
What is Advanced Search
This tab allows you to access the open and closed provider cases.
What is The Cases tab.
These plans are intended to stay in the background
What are Passive Networks
This is The branch of medicine concerned with the health care problems of adults.
What is Internal Medicine
Claims from the various types of facilities can be broken down into what two categories
what are Room and board and Miscellaneous charges
Benefits aren't tiered in this kind of network
What is A discount network
This style plan has one level of in-network/preferred benefits or maximum savings benefits only
What is Concentric Model
What are networks in areas where we don't have many providers contracted
what are rental and rural networks
This is The branch of medicine for the diagnosis and treatment of diseases and disorders of the female reproductive system.
What is Obstetrics & Gynecology
This is where you will go to locate providers participating with a member’s plan
Where is GPS Find Provider
This section always displays as collapsed unless you click on it to manually expand it.
What is Update and Verify Address
This is the second section of the Find Provider sub-tab
What is Search by Name, Specialty or Procedure
There are two ways provider information may be documented on this screen
What are Auto-documentation and Manual documentation
This is The branch of medicine concerned with the healthcare of children.
What is Pediatrics
What is a group of contracted providers who have agreed to treat Aetna members at negotiated rates
What is a Network
What is a nationwide network of providers for most plans
What is Aetna Health Plan Network (AHP)
This screen defaults to in-network providers.
What is The Provider List screen
These terms refer to how network partner up... or not
What is No Reciprocity, Limited Reciprocity, and Full Reciprocity
What is needed to be a legally qualified physician
What is
What type of facility needs to be paid at the preferred benefit level per Federal Mandate
what is A Military Treatment Facility (MTF)
This is the acronym for a screen for providers
What is PDS
This is a course that is taken for a specific states updates
What is NY Directory Accuracy and Update Requirements (845007) course