MCR
Where would I route a claim/MCR if was readmission 598 Review
what would be SEND ESC EMAIL ONLY TO: mcr_readmissions_sme@optum.com/SME's - Audrey Carbaugh, Belkys Garcia // Manager - Nikki Hall
What is denial code 1251
What is member has no out of network benefits
Who is Your Director of Escalations/Swat
Who is Misty Kline
What Holiday do we celebrate March 31
What is Easter
What person on Team Mars Lives in Georgia
Who is Kim King
Who would be my escalated contact for MCR Amended Contract/procedure code change
Who is Cheryl Winchester - SME/Terry Lewis - Manager
598 REVIEW CODE
WHAT IS MCR RE-ADMIT CODE
Who is Misty's Boss
Who is Holly Kross VP of back office teams PSO
What Holiday do we celebrate on May 5
What is Cinco De Mayo
What person lives in Tennessee
Who is Donna Mars
For MCR Regular Reconsiderations, who is our escalated contact?
Who would be Eunbin Suh (EB) - SME /Sarah Payette - Manager Garry Delgin - OGA Mgr
What is a MCR Denial Code 527/537/544/558/1580
What is MCR Manual review for Wound Flap Review
Who is our Manager of Escalations/Swat
Who is Sarah Griffith
What Day in November do we celebrate Veterans Day
What is November 11
What person/People live in Florida
Who is Amanda,Kim D, Sherry, Teresa, Kerrie, Rebecca,Penny, Odessa.
If we have a claim still pending MCR Readmit 598 and Provider sent records in July 2023,what would be first step in getting claim reviewed.
We would pull ORS from where sent in July-route to RE-ADMIT, then escalate the email, wait for response. If no response in 5-7 days send another email to our contact. Even though in backlog we still push. per abrasion now 8 months.
What is a MCR denial code 524
What is manual review for Medicare non covered Procedure code
Who is Holly Kross's Boss
Who is Wayne White VP of ALL Provider Services Operations
We Celebrate this Day in January for Martin Luther King Day.
What is January 15
What person lives in Arizona
What is a 1139 MCR Review
what is readmit review
What is MCR Denial code 5515
What is manual APC PRICING
Who is Kristie Richardson, SR VP Of Provider Operations
What is your Supervisors Birthday?
What is September 21
What people live in NC/and WV/MD
Who is Michelle, Cindi, Dondest