Bright Health Plan 101
Provides affordable health insurance with a great experience for everyday individuals.
What is Bright Health?
Pharmacy Benefit Manager.
What is Elixir?
Types of authorization requests.
What is Inpatient, Concurrent, Prior Auth/Pre-Cert, and Retro?
CareRadius VPN network site.
What is Barracuda?
IFP and MA
What is Individual Family Plan and Medicare Advantage?
Bright Health Values
What is Purposeful, Authentic, Brave, Positive, Respectful?
Program to keep Medicare Advantage members active and healthy.
What is Silver&Fit?
These CPT codes are approved if:
The servicing provider is in-network
The place of service is in-network
What is Level 1 Prior Authorization?
Can be used by multiple internal partners, as well as submitting referrals between care management programs.
What is Referral Survey?
TAT
What is Turn around times?
Making healthcare right. Together.
What is Bright Health Mission?
Hearing and DME
What is Homelink?
EOC/COC
What is Evidence of Coverage and Certificate of Coverage?
Provides a mechanism for the user to view all CR® member documentation regardless of the workflow record the documentation is associated with.
What is All Documents tab?
OON
What is Out of Network?
BHP President and CEO
Who is G. Mike Mikan?
Circulation
What is the company that provides free rides for non-emergency medical transport for both MA and IFP members?
Governing body who accredits and certifies healthcare industries.
What is URAC-Utilization Review Accreditation Commission?
Allows you to enter requests for treatment from either a provider or a member requesting care?
What is Authorization process?
SCA
What is Single Case Agreement?
BHP Current 13 States
What is- Alabama, Arizona, California, Colorado, Florida, Illinois, Nebraska, New York, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee?
Company contracted with BHP to provide nutritious meals for members who have had an admission to the hospital.
What is GA Foods?
BHP Medical Directors
Who is Dr. Christine Gilroy, Dr. Gerry Davis, Dr. Irene Baral, Dr. Cory Coldwell?
The process begins when the Escalation Nurses in Kansas City are notified of a request for OON services.
IRO
What is Independent Review Organization?