PE General Knowledge
This team works closely with our managed care contracting team, also ensures enrollment related issues are resolved and processed timely.
What is "The Payer Team"?
A Guarantor must be 21 years of age or older, and not grossly disabled.
What is "False"?
Utilized to submit PERFs, manage enrollment documentation, and submissions to the payers.
What is "CARE"?
The accumulation of charges that are still accruable, but are at risk of becoming bad debt.
What is "Risk"?
This birthstone, which is believed to bring clarity of mind and protect against intoxication.
What is "Amethyst"
What is the most widely consumed fruit in the world?
What is "Banana"
We handle two types of enrollment in Provider Enrollment Department.
What is "Delegated and Non-Delegated"
Managed Care plans may include government and non-government plans.
What is "True"?
Northwell Health’s billing system. Is a web-based portal service that provides a secure gateway to retrieve and enter data.
What is "GECB"?
A person who agrees to be responsible for payment, must be 18 years of age or older, and not grossly disabled.
What is "Guarantor"?
Celebrated in many countries, including Brazil and Italy, with parades, masquerade balls, music, dancing, and elaborate costumes. One of the most famous is the one held in Trinidad & Tobago.
What is "Carnival"
Which city is often referred to as the birthplace of jazz?
What is "New Orleans"
Initiates and supports enrollment with government and commercial insurance plans for providers employed by Northwell Health Physician Partners.
What is "Provider Enrollment"?
A subscriber is also known as the policy owner or policy holder.
What is "True"
Future integrated solution that will result in one patient record across Northwell to drive and enhance care coordination and an improved user experience.
What is "EPIC"
A specified amount, usually on an annual basis, which a patient must pay towards medical expenses before the insurance company will begin paying.
What is "Deductible"?
Primarily celebrated in the US and Canada in February, the UK and the Netherlands observe it in October.
What is "Black History Month"
What is the main ingredient in the Mexican dish tamales?
What is "Masa (corn dough)"
One step in PE is to identify top payers and file the application in payer-specific format.
What is "Payer Submission"?
Coordination of Benefits: Benefits under two plans are limited to no more than 100 percent of the claim.
What is "True"
Application and database maintained by Medical Staff Services; it is the source of truth for provider credentialing information.
What is "Echo"?
A report that is created in GECB DBMS.
What is a "Query"?
Also known as the Spring Festival, it is celebrated with family reunions, feasts, dragon and lion dances, fireworks, and giving red envelopes with money for good luck.
What is "Chinese New Year"
Declared the best city in the U.S. for vegans and vegetarians, thanks to its abundance of veggie-friendly restaurants, farmers markets, and community gardens
What is "Los Angeles"
Web-based management tool that analyzes, prioritizes, and delivers relevant information to the appropriate individuals for quicker follow-up.
What is "Enterprise Task Management or ETM"?
ERA, is a paper version of a claim reconciliation. Typically included when a paper check is remitted to a provider by an insurance plan for services rendered.
What is "False"?
integrates workflows across multiple Centricity Business applications, including the Transaction Editing System, pre-adjudicated payer edits, post-adjudicated payer edits, and eligibility.
What is "ETM"
A group of private Physicians who join together in an association to contract with a managed care organization.
What is "Independent Practice Association or IPA"?
Held annually in February and March, this festival is a gastronomic delight featuring culinary experiences from around the world.
What is "Dubai Food Festival"
This city in Texas is known as the "Live Music Capital of the World"
What is "Austin, Texas"