Premier
Name 2 Health Plans we manage NOT named Wellcare
Devoted, SOLIS, CarePlus, Amerihealth, Humana, Florida Blue
Name the 5 pages needed to be returned for contracting.
Page 1 of Contract
Sig Pgs 29 and 40
Claims Payment Datasheet
W-9
When a provider wants to add a Doctor to their already active TIN, which department handles?
Credentialing
Member's have a Free Annual Comprehensive _____ _____ at no cost or copayment.
Eye Exam!
Which Health Plan are we getting ready to recruit/expand with in 2025?
Devoted!
On the group page, which box needs to be checked for the Main practice address?
Primary
If the Mailing/W-9 Address is being updated, what do we need besides the Update form?
W-9
When any W-9 information changes, we will need a new W-9 in order to proceed with changes
What can a member get with their Allowance?
Member's Allowance can be used toward the purchase of any pair of glasses/contacts.
some office may have certain high end brand they cannot use allowances for, however this is very rare
Premier recently merged with another company. What is the name of that Company?
Health Network One!
What color background indicates a terminated or archived location/provider?
Yellow!
What department do we send new W-9's to?
Accounting!
What happens if a Member wants both Contacts and Glasses? Are they able to? Why?
The member's benefits can only be used towards the same kind of materials and cannot be utilized for both Contacts and Glasses
Name 3 different departments outside of our team here at Premier.
Claims, Claims Support, Accounting, Credentialing, Configuration, HEDIS, IT, Medical Admin, MAPS
What two pages do the Practitioners need to be linked to?
Contract Page and Group Page/Location
When Terminating a Practice/group, which two attachments are needed?
Termination Form and Acknowledgement of Termination Letter.
When is a member responsible for payment on glasses or contact?
When the total billed charges exceeds the Allowance amount. Members are responsible for any amount above allowance.
Who is our VP of National Network Management?
Anna Pinera!