This is the tab we use enter to find members precertification history.
What is PM/Event History?
SPU Benefit in ASD.
What is Surgical Benefit?
Does not Require a Referral.
What is an PPO?
15823 is an example of "this" kind of code.
What is CPT-4/Procedure Code?
System we use to process payments for members monthly premiums.
What is PNC Biller?
These are the 3 steps that we take to close a member account in ASD.
What is QSR, MSR and Spongebob/Contact Summary?
DME Benefit in ASD.
What is Durable Medical Equipment.
The meaning of PDP.
What is Prescription Drug Plan?
J1576 is an example of "this" kind of code.
What is HCPC code?
Website we would go to send member a coupon booklet for premium payments.
What is TransAmerican?
Takes you back to where you started?
What is M360
Benefit I would find MRi and CT Scans under in ASD.
What is IMG/ Complex Imaging Benefit in ASD?
A plan paid for by Employer.
What is Group or Employer Sponsored Plan?
053.15 is an Example of "this" type of code.
What is a Diagnosis Code?
This is where I can find things like My VDN List and MAP tool.
What is What is WIKI Tool?
Where I would go to find member benefit usage, both financial and non-financial.
What is the Accumulators Sub Tab?
This is where we would find additional benefits attached to a members policy.
What is a Benefit Rider?
Has both In and Out of Network Benefits.
What is a PPO Plan?
Inquiry we would use in Rumba to find out what benefit a procedure is covered under.
What is the SERVICE CODE INQUIRY?
The "S" in QUEST stand for this....
What is Sensitivity?
Where I would go to see if an EOB was mailed to member.
What is the Correspondence Sub tab?
SNF Benefit id ASD.
What is Skilled Nursing Facility?
The meaning of MAPD.
What is Medicare Advantage prescription Drug Plan?
System we would use to see if a CPT-4 code requires precertification.
What is ASD (Benefit Tab>Benefit Detail Sub Tab)?
What PEAS stands for....
What is Paraphrase, Empathize, Appreciation and Summarize?