Claims
Regarding Blue Squared, this line gives the payment of the claim information non-allowed amounts, and patient responsibility. It’s the MOST used line on B2.
DF
PHI
Protected Health Information
Name 2 services that members with Medicare primary will need to get an authorization for through Anthem as FMCP will pay as primary.
Home Infusion, Hearing Aids, Routine visits
After the date and work local is found on ERTS, click this to look at the report to locate the member.
The number highlighted in Report Id column
Benedict Cumberbatch plays this Doctor in the Marvel Universe movies.
Doctor Strange
This is where you go in V3 to check deductibles.
Accumulators
ACA
Affordable Care Act
Our online behavioral therapy service is through this vendor.
TalkSpace
A member is already receiving disability credit hours and disability checks for one condition He wants an additional 26 weeks of pay for another condition to have back to back disabilities. This needs to be done in order to make this possible.
A member can get a second disability but only if he/she returns to work for at least 1 full day.
You may call this Doctor if you cannot figure out what is wrong with an animal.
Doctor Dolittle
Item edits that are highlighted in blue means this.
The edit has been overridden by a processor.
AD and D
Accidental Death and Dismemberment
This is the program member's should use if they have medical expenses while traveling outside the U.S. Be specific.
BCBS Global Core Program
A retired member recently divorced but is now remarried and now he wants to add his new spouse to his plan. This is the answer the advocate should give.
A retiree cannot add a spouse to the plan after he retires if they were not eligible at the time of retirement and did not lose their primary coverage.
Dependent children cannot be added at any time.
This Doctor says things like "Why make trillions when we can make billions?" and "Why must I be surrounded by frickin' idiots?". He also has a cat named Mr. Bigglesworth.
Doctor Evil
This is the denial for a claim that requires pre-certification, but does not have one. Be specific.
Medical Records Required
ERTS
Electronic Reciprocal Transfer System
MetLife’s group number for FMCP members.
304133
This is the piece of information that is not required to be obtained for a RETIREE member that passes away that we would need for all active members.
If death was natural or accident
This doctor has no bed side manner and a limp, but will have you diagnosed and fixed up in around 42 minutes.
Doctor Gregory House
This is what is means when there is an IP in the claim alert.
It is a local/Anthem state claim. It cannot be looked up in B2.
COBRA
Consolidated Omnibus Budget Reconciliation Act
For the first 30 months of dialysis, ________________is primary and ______________is secondary.
FMCP, Medicare
After verifying the member qualifies to make a self-pay, this should be checked before quoting the self-pay.
Check for credits on the account
This Doctor has two hearts, hails from Gallifrey, and has a Time and Relative Dimension in Space machine.
Doctor Who