Claims
Only 12 months from date of service
WHAT IS FILING LIMIT?
I want more money for this service.
WHAT IS RECONSIDERATION (OF PAYMENT)?
Having to repeat yourself in conversation.
What is the mute button?
The information contained in this manual applies to all providers for all products administered through HAP, Alliance Health and Life Insurance Company and HAP Preferred.
What is the provider billing manual?
A plan where Medicare is Primary and Medicaid is Secondary.
What is MMP?
The 11 digits needed for drugs
WHAT IS THE NDC?
You can find me under the Remittance tab: Various answers allowed.
WHAT IS check#?
Ok Can everyone see my screen?
What is Teams?
What is the Procedure Reference List?
Dual Eligible Special Needs Plans enroll individuals who are entitled to both Medicare and medical assistance from a state plan under Medicaid
What is DSNP?
This tells you if patient was seen in the office, emergency, UC, etc.
WHAT IS PLACE OF SERVICE (POS)?
Where providers can check claim status, benefit status and obtain RA’s.
What is the provider portal?
Phrase stated when attempting to speak when others are trying to speak at the same time.
What is 'Sorry go ahead"
Enter the subscriber's 9 digit Facets ID
plus 00 suffix to view
What is the Summary of Benefits and Coverages? (SBC).
To be eligible Beneficiaries must be a permanent resident of Michigan and have original (Medicare Part A and B).
What is HAP Medigap Plan?
In Facets when a paper claim is submitted and manually processed you find the microfilm # here
IS CLAIM INFO TAB?
Where we document all provider calls and inquires
What is Pega?
In virtual land I can be anywhere I want to be.
What is virtual backgrounds?
I can review all PI corporate application resources by navigating here.
What is SharePoint?
Dental, Vision, Hearing, OTC, Fitness are offered to MA members.
What are supplemental benefits?
Which status code, found in Facets, tells you claim was only priced
WHAT IS 14?
This is the process by which a health insurance company determines if it should be the primary or secondary payer of medical claims for a patient who has coverage from more than one health insurance policy.
WHAT IS COB ( COORDINATION OF BENEFITS)
Attempting to join a meeting with no other colleagues present.
What is the Lobby?
Providers can send their claims to a service provider (billing service or claim software vendor)
What is Clearing House?
Is a Jointly funded state-federal program that provides healthcare coverage to low-income beneficiaries.
What is Medicaid?