Plan specifics
How long can a PCP be back dated
What is the name of the job aid for Glucose monitorrs?
IBC preferred diabetic supplies
What is the procedure to follow if the claim denied due to no referral on file
Request a backdated referral if still within time frame or an appeal.
What are the options if the member reached out the maximum visits for physical therapy?
No options.
What is the name of the little Mermaid's daughter
Melody
How long has the member to start an appeal
180 days from the processing date.
what is the job aid with the process to update the member's phone #
Member email and phone number update process
If the claim denies due to COB what is the procedure to follow
Update COB if applicable or obtain the EOB from the primary insurance
What would be an alternative if the member has an HMO plan wants to go to only NY providers
Guest membership or changing to a POS or PPO plan
Mention a movie name without the letter H
....
What are the services that require a referral for a DPOS plan
Lab, radiology, PT, Chiro and acupuncture
What is the name of the job aid for Colonoscopy services
Colorectal cancer screening
if a claim denied due to no authorization on file, what are the options
backdated auth no longer than 48 hrs after DOS or appeal.
What is the coverage for a breast pump
Preventive coverage INN no precert needed. Coinsurance 100% and no hospital grade limitation.
Mention 2 super heroes who wear no cape
Spiderman, Iron man, Wonder woman etc...
What does "pare" stand for
Pathology
Anesthesia
Radiology
Emergency
what is the name of the job aid where we can check which services require a referal or authorization
Managed care plan details
if a claim denied due to incorrect alpha prefix, where can you check the alpha prefix submitted by the provider
HRP
What is the frequency limit for a Dexa scan or bone density test
1 every 2 years. More than 1 if medical necessity found.
What is the name of one of the Ninja Turtles
...
What are the limitations of an EPO plan
No OOA coverage.
name of the job aid with the international benefits listed
Blue cross blue shield global core
Provide 2 requirements for an ambulance claim to apply for a pear adjustment
OON
Emergency revenue code 450
Hospital claim for the same DOS
If a member's account shows the alert that their group has opt in for weight loss medication, what does it mean
they might coverage, still needs to be connected to Optum.
Give the name of 5 planets