Systems
Abbreviations
Claims
ESI/ESD
Miscellaneous
100

Precertification Lookup Tool - used to determine if PA is required

What is PLUTO?

100

EOB

What is Explanation of Benefits?

100

Type of claim submitted for an inpatient stay

UB-04

100

Locate Rx Prior Authorizations

What is PA Hub?

100

Anthems Dental vendor

What is Liberty Dental?

200

Locate prior authorizations status

What is MAS Toolbar?

200

LIS

What is Low Income Subsidy?

200

Queue to request adjustment to claims

What is ASA CR ADJ?
200

Government program for Medicare beneficiaries who have limited income

Low-Income Subsidy

200

Used to emulate a members online profile

CAD Admin Tool

300

View status, reissue, or void a check

What is Check Inquiry Tool?

300

EOC

What is Evidence of Coverage?
300

Code describing patients condition (ICD-10)

What is a Diagnosis code?

300

Used to locate drug accumulators

What is Account Summary?

300

Anthem's Hearing Vendor

What is HearUSA?

400

Used to order Provider Directories

What is CustomPoint?

400

LEP

What is Late Enrollment Penalty?

400

Codes billed on Outpatient and Inpatient Facility claims

What are Rev Codes (Revenue codes)?

400

Override for members leaving the country for less than 6 months

What is a vacation override?
400

Used to review provider disputes and appeals

PEGA

500

Used to store EOBs, invoices, provider remits, etc.

What is OnDemand/Webi?

500

POS (no, not that one)

What is Place of Service?
500

Sends Submission Format (SF) for ITS claims

What is Host Plan?

500

Required for a Lost/Stolen medication override

What is a police report?

500

Anthems initial decision regarding the provision of medical care/services

What is Organizational Determination?

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