FEDVIP
SNF Therapy Accums
OON Pricing
Christmas Movies
100

The acronym FEDVIP stands for....

What is Federal Employees Dental & Vision Insurance Program?

100

The accumulator for SNF therapy.

What is L20?

100

FMR400 means we price at this percent.

What is 400%?

100

The movie Miracle on 34th Street is based on this real life department store.

What is Macy's?

200

The claims bin you would route claims with the edit HE  DETAIL SPECIAL HANDLING REQUIRED.

What is the VP3 bin?

200

# of visits you would manually add to the accumulator when there are more than one type of therapy on same dos.

What is 1?

200

The rating system for our National Nonpar Default Rate.

What is NNPDEF? 

200

In Home Alone, the city that the McCallister's are going on vacation to when they leave Kevin home alone.

What is Paris?

300

The claims bin you would route claims with the edit WM  SPECIAL HANDLING LEVEL.

What is the SPH bin?

300

Type of bill 223 stands for.

What is Skilled Nursing Interim - Continuing Claim?

300

The tool used to assists in the pricing of Ambulance, Ambulatory Surgical Center (ASC), End-Stage Renal Disease (ESRD), Home Health Care, Hospice, Skilled Nursing (SNF), and Inpatient Psychiatric Facility (IPF) claims.

What is the Burgess Pricer Inquiry Tool (BAPT macro)?


300

The Grinch is described as this.

What is stink, stank, stunk?

400

Primary payer when member has FSBP/RCBP and FEDVIP.

What is FSBP/RCBP?


400

The information that needs to be included in your member note after updating accums.

What is the claim number(s), number of visits in each claim and the running total?

400

The e.Policies page you use to review the hierarchy for your nonpar claim scenario.

What is Nonparticipating Provider Compensation (Pricing) - Traditional Claim Processing?

400

In Elf, the reason Santa's sleigh crashes in Central Park.

What is a shortage of Christmas spirit?

500

The message you would enter in your route notes when forwarding claim to Aetna's FEDVIP.

What is "FEDVIP do not route back"?

500

The tool you can utilize to review members claims.

What is the ACAS History Reconstruction Tool? 

500

Non Par Inpatient Psychiatric Interim Claims should be denied with this action code. 

What is NP3?

500

The gift Clark's boss gives him as a Christmas bonus.

What is a year's membership to the Jelly of the Month Club?