Pharmacy
The system used to check prior authorizations
What is PA Hub?
The system used to check the status of an appeal or complaint
MedHok
System used to check Medicaid eligibility
What is eCIS?
IPA Code indicating out of network provider
What is IPA 09?
Program in order to have the added Utility and Healthy Foods benefits
What is SSBCI?
The system used to submit a coverage determination
What is PromptPA?
What is 30 days?
System used to find an in-network provider?
What is the Provider Directory?
5 Digit Numerical Code
CPT Code
What is Medical Transportation?
The system used to check pharmacy claims
What is ESI/CSP/Evernorth?
Standard processing timeframe for Part D Redetermination
What is 7 days?
System used to check Pay Policies
MCN Policy Manager
CCD Topic used for discussing claims
What is General Inquiry/Discussed Processing?
This plan can be primary without Medicare
What is UPMC CHC w/LTSS?
This determines a SNP Member's Copay Cost Sharing
Topic used to file a PAS Hours Appeal
What is Appeal Medical/Dental/Vision Authorization?
System used for dental
Claim Type for Hospital
What is Institutional?
Servicing provider for SNP hearing aid coverage
What is Amplifon?
These medications can be billed to the member's secondary insurance
What are Part B Drugs?
This is used to submit a DHS Hearing Review Attendance request
What is the Concierge Portal?
Used to check Medical Procedures/DME authorizations
What is HealthPlaNET?
Member share showing on the SNP claims - our next step
What is check CHC claim submissions?
Social transportation for CHC members is handled by this department
What is the SCA department?