Eligibility
This symbol indicates that a patient's insurance is no longer active.
What is a red x?
This portal is used to check authorization requirements and status for a UHC Community plan.
What is UHC?
When looking up patients by the accession number, this symbol is used.
What is "@"?
The A-Team has verified with the carrier that authorization is not required
What is 10- Verified Not Required?
The carrier has denied authorization for this exam.
What is 14- Denied?
This symbol will appear for a patient with the wrong carrier code selected.
What is a yellow question mark?
This portal is used to check authorization requirements and status for an Aetna Commercial plan.
What is Carecore?
When looking up patients by the MRN, this symbol is used.
What is "#"?
Authorization has been approved by the carrier.
What is 9- Auth Approved?
The non-PAP referrer has initiated the authorization with the carrier.
What is 6- Non-PAP Pending Review?
This resource is used to confirm carrier codes.
What is the IBSR?
When taking a screenshot of an approved authorization, to be considered valid the screenshot must have the authorization number, the CPT Codes & approved quantity, the site it is approved for (if applicable), and this.
What is the expiration date?
When working with CPT Changes, when do we begin handling downcodes?
The Non-PAP Referrer has not yet initiated the authorization with the carrier
What is 6- Non-PAP Not started?
What is Blank / 1's / Null?
This resource is used to find a portal or phone number to confirm eligibility information for a patient.
What is the Authorization Team Guide/Insurance Grid?
When working with NIA authorizations, we must always remember to document this in our IVT notes even if authorization is already on file. If we don't, it will be difficult to pull up the authorization on the web.
What is the Tracking Number?
When working with CPT Changes, when do we begin handling upcodes?
What is ASAP?
The site on the authorization needs to be updated with the carrier and the A-Team was unsuccessful in updating it
What is 8- Site Change?
The patient must contact the carrier on or before the Date of Service to change the site of the procedure.
What is 8 - Member Scheduling?
Instead of performing an eligibility override, this additional step is needed after confirming eligibility for a non-configured carrier.
What is checking off the Insurance Verified box?
When checking authorization requirements for Cigna on Medsolutions, the only time we can use a screenshot to confirm no authorization required is when we get this response.
What is "CPT Code Does Not Exist"?
When making outbound phone calls, we must always state this at the beginning of the call.
What is "I'm calling on a recorded line"?
The CPT / Exam needs to either be updated in RIS or on the authorization
What is 8 - CPT Change?
Insurance for the patient is inactive