Eligibility/Group
The most recent effective date and plan type for MBR ID 100668792-01.
What is 01/01/18 and PEBB SW?
The name of the closest located internal medicine provider to the home zip code of MBR ID 100697483-00.
Who is Dr. Jeffrey Brown?
The largest network located in Oregon and SW Washington.
What is the Signature/EPO network?
ASO stands for this.
What is Administrative Services Only?
The department responsible for taking phone calls from both members and providers and answer various questions.
What is YOU GUYS?! Customer service :)
The original effective date and plan type for MBR ID 100547608-01.
What is 11/12/14 and SAIF?
The name of the medical home located nearest to MBR ID 100877867-00's home zip code.
What is the Salem Health Medical Clinic - Keizer?
The network that our choice members have to use in order to get in-network benefits.
What is the PROVCHOICE network?
The type of plan MBR ID 100118651-00 is on and what is unique about this plan type?
What is personal option?
Personal option means the member only has in-network benefits.
The team responsible for inputting employer group information into the system and making updates to member accounts such as eligibility and addresses.
What is Membership Accounting?
The termination date and plan type for MBR ID 100758672-01.
What is 11/01/17 and Portland School District?
The number of cardiologists located within 5 miles of the home zip code of MBR ID 100894512-00.
What is 35?
The two national networks used for Southern Idaho (Hint: Network Layering)
What is Brightpath?
What is PHCS/Multiplan?
The two plans that require medical homes on file and referrals to see specialists.
What are PEBB and OFC?
This department is staffed by clinical physicians and nurses and review claims for medical necessity as well as review prior authorization requests.
What is HCS? (Healthcare Services)
The original effective date and group # for MBR ID 113109632-00.
What is 01/01/17 and 106528?
The number of male urologists located within 25 miles of the home zip code of MBR ID 100547288-00.
What is 13?
The network used for PHSAK/MT/CA/WA/Swedish/Kadlec/Pacmed.
HSA stands for this.
Health Savings Account
*Bonus: What is different to HSA plans when it comes to more than one person being on the plan?
The vendor responsible for sending out member ID cards.
What is Clarity?
The most recent effective date and group # for MBR ID 113131041-00.
What is 11/13/16 and 105052?
The number of Tier 1 female OBGYN's within 25 miles of the home zip code for MBR ID 100147963-00.
What is 1?
The network used for St. Joseph Northern CA EPO Tier 2.
What is Anthem?
If a PEBB member is on a 100+ plan, it's because of this.
They failed to complete their HEM and therefore their deductible is an additional $100.
The vendor responsible for reviewing prior authorizations related to high tech imaging.
What is AIM? (American Imaging Management)