Request Profiles
Eval only, Consult, >2 visits, Eval and Advise.
What is P3 (evaluate only)?
Colonscopy screening- Gasterology.
Specialy Referral
UIN, Event Classification, Referring Provider, Diagnosis
What is Authorization Main?
B, M, T
Reach out to lead, supervisor, or manager.
What is Post Question.
Eval and Treat, Consult and Manage, Semi-Annual Follow Up, mentions COC
What is P1 (Evaluate and Treat)?
Behavioral Health, Physical Therapy, Speech Therapy, Occupational Therapy.
What is an outpatient authorization?
Subscriber vs. Dependent
What is Member Snapshot?
25 miles increase to 10 miles (exception HI).
What is radius search?
Sends a case to the authorization queue for processing.
What is Route Auth?
COC with named provider, Auth expiring, Follow Up, does not mention eval and treat.
What is P4 (extension)?
Office visits with no testing mentioned.
What is specialty referral?
Plan Override, MTF Directed Referral, Date Request Received, MTF NPI and Referring Provider Name.
What is the intake tab?
Dermatology, Neurology, Pediatric Cardiology, Sleep Medicine
What is specialty?
Used to track Breaks, Lunches and Training
What is Non-Production?
COC with named provider, mentions eval and treat.
What is P1 (Evaluate and Treat)?
Diagnosis Description:Evaluate Only
What is specialty referral or 2nd opinions?
Service Lines, CPT Codes, Quantity, # of visits.
What is the Services tab?
Update the provider fax number and demographics.
What is Provider Snapshot?
Closed, Pause, Fax Back, Inpatient, Development are all.....
What are dispositions?
Injections, Labs, Testing, Procedures.
What is outpatient authorization (Route Auth)?
Diagnosis Description: Eval and Treat
What is either (depends on the specialty)?
To complete data entry.
What is Save and Close?
Used to check for limitations or exclusions when completing a radius search (EDI).
What is the Provider List?
Tracks Productivity, Paused and Non-Production time.
What is Task Log?