Benefits
Benefits two
ELIGIBILITY
TOOL
100

This benefit has no out of network benefit and will always be in network

 What is Emergency services

100

This is needed to validate the member

MEMBER ID, Name, DOB

100

with this app, we can pull ced, cpf and

CORKBOARD

200

This is the disclaimer that we normally say for the accumulators

I should also inform you that the dollars amount and the visits accrued are subjected to change based on claims processed at the time of this call

200

The member has an OAP IN, this means

What is the member has no out of network benefit

200

in this tool you can find the member account has been updated and what function key  would we press to see it

What is CED and f1
300

When this service has been confirmed, you can provide office, pre&post natal and inpatient hospital and what service and benefit is this

pregnancy and maternity

300

To read the correct benefits for surgery where would you read

place of service, office, facility and professional

300

in CED what is the function on the member account that we press to see other insurance

press the F9 key

300

In cpf where do we find that the provider is either a specialist or PCP and where would we go to see if they are contracted

what is summary page and network relations list

400

This benefit is used for skilled nurse facility and sub acute

What is Other Inpatient facility services

400

The network id shows that the provider is contracted with ash and that the zip code is 90210, what would be the network id for ash and is MNR required

What is NW360, NW353 and yes

400

on the eligibility tab where would we know if the account is either an alliance or payer/third party

on the eligibility & claim system / alerts

500

MNR is required after the 5th visit, can this requirement be different and how

BA says otherwise, and SALT will state if the service should be through ash or not

500

This is needed to pass HIPAA

What is TIN, provider name/office/facility name, member id, name and DOB