Product Codes
Providers
Service Areas
Workflow
MISC
100
This product code is for CCPOA plans.
What is 0003?
100
Children should be assigned to a pediatrician or this type of provider, when possible.
What is family practice?
100
After assigning a PCP, press this button to resolve any edits.
What is F2?
100
The spreadsheet filled out when a member is an existing patient, and the PCP is not accepting existing patients.
What is an Edit Lift?
100
Entering this in the Provider Number field, will trigger the randomizer.
What is 54220000000000?
200
This product code is for Access+ plans.
What is 0015?
200
If you cannot locate a pediatrician or family practice doctor, you may assign this type of doctor to children.
What is General Practicioner?
200
This is the first ZIP code used when assigning a PCP.
What is the mailing ZIP code?
200
A cancelled PCP is sent to this box.
What is the Term/Tx email box?
200
This system is updated once or twice a week.
What is blueshieldca.com/fap?
300
This product code is for NetValue plans.
What is 0019?
300
Children under age 18 cannot be assigned to this type of PCP.
What is Internist?
300
If a member does not have a valid mailing, home or eligibility ZIP, you must do this.
What is send an OOA letter?
300
Newborns must be enrolled in Mom's IPA during this time (or Dad's IPA if mom is not enrolled on the plan).
What is the birth month?
300
The Provider Network Inquiry File is commonly known as this.
What is LMOM?
400
Product code 0003 can always have this medical group (IPA).
What is Sutter?
400
This type of doctor has an "S" in the REL column in LMOM.
What is a specialist?
400
If the mailing and/or home ZIP does not work, use this ZIP to assign.
What is the eligibility ZIP?
400
When assigning a PCP you must not exceed these mileage guidelines.
What is 15/25 miles?
400
This shows that a PCP is in highlight.
What is a "Y" in the error indicator?
500
This plan does not have a product code.
What is EPO?
500
When a provider has an "N" under the N column in LMOM.
What is not accepting new patients?
500
In addition to mileage guidelines, the ZIP code is used to validate this.
What is the IPA Service Area?
500
Instead of sending an Edit Lift Request, a processor can trick the system by doing this.
What is changing the Date of Birth?
500
When an ID Card errors, it will hit this report in SAW.
What is the Trigger Report?
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