Sam I am
our company name
Dentaquest
you must do this for every call
validate or authenticate
to validate a provider account, you must get these 3 pieces of information
TIN or NPI
providers full name
address of the location
the name of the system we use for Member's & provider's accounts
Windward
the name of our database where we get the answers to most questions asked of us
Knowledge Base
This is the type of insurance we handle
dental
a member must give you these
full name & DOB
the provider must provide this information for the Member's account
first & last name member ID# or member's DOB
"this" is where the template for the call notes go
Inquiry
"this" is the "extra search" that can find information on any page
CTRL F
this is the type of plans we handle
government
these are the 4 pieces of information a member can give you if they don't know the member number
address on account
phone # on account
last date of service
name of the last provider seen
" B O B " stands for this
Breakdown Of Benefits
Government, BCBSM, EMBLEM & MassHealth are examples of "this"
Business units
article 2057
Authenticating Callers (PHI, Windward, and Knowledge Base)
we do NOT handle this type of plan
commercial
We can NOT use "this" as a piece of information
social security number
what is the difference between "Par" &"Non Par"
Par- participating
Non Par- not participating
"this" is where you look for the name of the person you can speak to for Member who is a minor
Gaurdian / HOH
Article 1998
Provider PHI Call Flow and Inquiry Note Template
we handle calls from these types of people
Providers & office staff
Member
health plan reps
on "this type of account, we can only talk to the member who is over 18 or the provider on record
confidential
When a provider calls in, documentation is done on the _________'s account
provider
you must be signed into "this" to be able to use this system
DentaQuest Virtual Desktop
"this" is the article that I would look in to find out how to validate a confidential member's account
1667