1
An Out of Pocket (OOP) amount paid at the time of service.
Copay
Standardly, children can stay on the policy till..
26 years of age
If a copay line says None or No Copay, this benefit line applies.
Physician/Addl Providers
HIPPA was signed in..
1997
Single Point Of Contact
SPOC - IT issues
Cost share between member and Aetna (CVS)
Coinsurance
List the 5 PCPs
General practitioner
Family practice
OB/GYN
Internal Medicine
Pediatrician
List at least 3 preventative services
Well Baby
Immunizations
Well Woman
You can bypass validation when..
there is an Emergency Situation
The system used to "shadow" the members website
My Assist/My Assistant
Specific amount paid prior to insurance kicking in.
Deductible
This is code is the reason why a member went to a provider.
ICD Codes
I room with 2 beds is know as..
Semi Private
An identifiable number assigned by Aetna to providers.
PIN
Where you go in ASD to update the members phone number
Member Preferences
Precert is needed if birth is over..
3 days vaginal/5 days C-section
Unlike Conventionally funded plans, ___ accounts are not always subject to state legislation.
ASC
I room with one ben is known as..
Private
3 or more beds
ward
The date the member started with the plan sponsor and had active coverage is known as..
Member Effective Date
Name at least 3 items not covered as personal convenience items in the inpatient hospital policy.
The department is responsible for helping members enhance their overall health and wellbeing.
Behavioral health department
Department Responsible for managing your flexible spending account
Payflex (FSA)
2 beds
semi-private
List all 4 types of documentation
Auto Doc
Point & Click
QRS/MRS
Limited Free Form