System
What must a provider do to search for an Aetna member in the Online Claims System?
a) Click the link that reads "searching for an Aetna member?"
b) Enter Aetna subscriber ID and patient's DOB
c) Enter the date of service
What should we do after verifying HIPAA?
COA
How old must a check be before a check trace can be performed for a provider’s check?
30 business days
Where can a provider locate their contract?
infocus
Which of the following are approved HIPAA verifiers for providers?
NPI and Tax ID
How old must a check be before a check trace can be performed for a provider’s check?
20 business days
a provider can locate their contract and fee schedule in inFocus.
True or False
True
What should we ask the member after your introduction greeting?
name
Simulate the following provider:
Provider ID: OH3728
How many labs do they have enabled?
3
What system would an independent provider use to file claims?
Online Claims System
What should we say before closing the call?
Ask if there was a resolution .
Have I answered all questions that you had today?
Is there anything else I can assist you with?
Search for provider OH3728. How many labs has this provider registered?
16
We must ask providers for their Log In IDs to simulate the Online Claims System.
True
What should we do at the close of every call?
Survey
A provider calls regarding 7 disbursements they have not received. You verify the following
- Disbursements are not negative
- Disbursements are not direct deposits
- Disbursements paid more than 30 days ago
Advise provider to go to Online Claim System and Contact Eyemed to submit check trace request