Facets Coding
Document where RX10/PR10 codes are found.
What is the Clinical Description List?
Due to enclosures, these appeals are done on Templates.
What are CALPERS appeals?
After used once the Evidence of Coverage is to be referred as this.
What is EOC?
Letter sent by intake.
What is an AckLet?
If an appeal is sent via Email, this is entered in notes on the admin log.
What is "emailed"?
The AMR Report does not need to be attached for this kind of determination.
What are Appprovals?
A group plan is takes effect in July of every year. We received a preservice appeal today. We would use a _____ EOC?
What is 2021?
Date on a completed appeals case file name.
What is the date the appeal was closed?
Claim adjustment code for facility claims.
What is AD10/FA01?
Enclosure that goes on ASO Buy-Up appeals.
What is the External Review Application?
This section of the EOC is quoted, "General Provisions, under subsection Time Frames for Internal Appeals Process".
What are 180-day Complaints?
The correct naming convention for URGENT appeals.
What is Last name_Firstbname_Subsciber ID_Appeal ID_What is being appealed_Pre_URGENT_Urgent Due date?