Sheakley History
The year was Sheakley founded?
1963
The President of Sheakley Unicomp
Shari Harper
Which Admin Team member reviews dx review documents?
Sheena D
What two type of Appeals do we see.
Bill Appeals and Claim appeals
What are 3 types of Initials that we see?
Initial Claim
Initial Claim/C9
Initial Claim/No Info
A charitable organization that Sheakley Supports?
Light House
United Way
Boys & Girls Club
The Director of Operations
Seanna Howard
The DX Review doc type does not apply to a document with the diagnostic was performed more than how many days after receipt by Sheakley UniComp?
60 days
A Claim Appeal has to be on a C11 form, True or False
False
When you have an initial and you are looking for the employer/policy # in the Employer search tab, what is a good tool to use to narrow down your search?
An asterisk *
Our mission statement
To be the the most respected provider of human resources & risk management solutions.
The Operations Supervisor
Sara Readnower
What information should go in the BWC comment box for DX review documents
Name of the test W/ body part
Name of provider and/or Facility
Date of service
If you have an appeal that has both a C9-worked and bills, which type of appeal should you index it as?
Bill Appeal
What do you do when you have a claim number that does not come up in the system, but the BWC website lists Sheakley as the MCO?
This means this is a claim that hasn't dropped into Sheakley's system yet, so you would index it as an Initial or Initial/C9 if it has a C9 with it and assign it to AnitaB and she will watch for it to drop into our system and then have a CRS or FROI process it.
Larry Sheakley is the CEO of Sheakley. What is the name of his son who became President in 2005?
Matt Sheakely
The UM Support Team Leader
Amanda Johnson
An order for a diagnostic test should be indexed as DX review, True or False
What do you do with an Appeal (claim or bill) that is in BB/WM status
Index as Claim Appeal or Bill Appeal (depending on which one) and in the local comment box put "Claim is in BB/WM status
What are the two statuses a policy # has to be in for us to use for an Initial document?
A (Active) and R (Reinstated)
The Sheakley's are involved in building the value of the community and give to many organizations throughout the city of Cincinnati. What is one organization that Larry's wife Rhonda is particularly fond of?
The Cincinnati Ballet
Who is the UMS Team Supervisor?
Amanda Berry
Emergency room notes that have a DX review mixed in and are the same date as the Date of Injury can be indexed as Meds, True or False
True
How do you index an incomplete appeal?
Still index as appropriate Appeal type and in your local comment box state "incomplete"
When you have an initial, but the policy # is in T (terminated status), how do you index the document?
Initial/No info - the employer is with a different MCO and the FROI team will need to do their proper research to find who the document should go to.