Platform Pathways
Where would you go to update the network status for a specific payer?
Payer/Contract Info Management or override specific payers in Payer Assignment/Status
Where would you go to see the collected gross profit for 2025 so far?
Reports > Profit Center Sales Data Report
Where do you go to find leads for a rolling 12 months?
AF OPS
Where would you go to find out what Parent Payer #27 is? What is it?
Payer Assignment/Status, Column 1; BCBS of TX
How do you find the children payer number for Molina SC Medicaid?
Payer/Contract Info Management > Select Entity > Search 'Molina SC' > Select Contract > Children Payer Tab > 1669 Molina SC Medicaid
What is the top deactivation reason for BP’s (M&B) for BCBS AR?
Out of Network
Where do you go to find out if we are contracted directly with AF URO?
Entity > Select 'Aeroflow Urology' > Search payer and check network status
Where is the Bar Chart button, and what does it tell us?
Payer/Contract Info Mgmt > Search payer > Next to AF OPS – provides lead summary, denial count/rate, sales $, and serviced patient/product info
What is the difference between Fee Schedule and Quote File buttons in AF OPS?
Fee Schedule = actual uploaded quote file/rates; Quote File = open inventory list
True or False: If we are contracted with AF URO and AF INC with the same payer, we can only service Incontinence Products under AF URO agreement?
False
True or False: The Payer Relations database is considered the “billing/operations engine”?
False – it's considered Aeroflow’s CRM
True or False: In AF OPS, the total leads shown are all leads for Aeroflow?
True - this reflects all leads regardless of referral source
Where can you find the breast pump-specific notes for a payer?
AF OPS > Expand payer (+) > Breast Pumps row > Scroll to 'Notes' section
Can you find timely filing information for each payer? If so, where?
Yes – Under 'Children Payer' tab, scroll all the way right
In what instance would you create a new parent payer file?
New agreement
In what instance(s) would you create a new children payer?
New agreement, different claims address, multi-state payor with limited AF contracts, or varying PA requirements