Departments/Vendors
The department that takes both member and provider calls.
What is the customer service team?
The topic that houses information on periodic health exams.
*Hint: Multiple correct answers
What is the Preventive Services or Healthcare Reform topic?
The name of the only hospital located within 5 miles of zip code 97068 for MBR ID 112960565-00.
What is Providence Willamette Falls Medical Center?
The three different types of plans that the commercial team is responsible for servicing.
What are Large Groups, Small Groups and Individual/Family Plans?
The name of MBR ID 100255202-03.
Who is Richard Rivera?
The vendor that sends out member ID cards and materials.
What is Clarity?
The topic that houses directions on how to order an ID card.
What is the "ID Cards and Member Materials" topic?
The number of results when searching for a medical home/neighborhood for MBR ID 113047871-00 within 5 miles of zip code 97045.
What is 8?
The three things needed to verify if a member is calling on themselves.
What are their first/last name, DOB and address?
The DOB for MBR ID 113158586-00.
What is 35?
The department made up of clinical staff that review prior authorization requests and claims for medical necessity.
What is Healthcare Services (HCS)?
The topic that has information on breast pumps.
*Hint: Multiple correct answers
What is the DME, Pregnancy or Womens Health topic?
The names of the two male, Spanish speaking orthopedic surgeons listed within 5 miles of zip code 97216 for MBR ID 100185415-00.
Who are Douglas Bald and Gavin Button?
The type of plan that only has in-network benefits.
What is the Personal Option Plan?
The original effective date for MBR ID 100663831-00.
What is 04/01/13?
The vendor used for high tech imaging prior authorizations.
What is AIM (American Imaging Management)?
The topic that houses information on circumcision benefits.
*Hint: Multiple correct answers
What is the Newborns, Surgery, Pregnancy or Mens Health topic?
The network that Dr. Ann Bridges, OBGYN, is a part of at 904 7th Ave for MBR ID 112865011-00.
What is the FCHN network?
The type of plan that MBR ID 112941351-00 is on.
BONUS: Did this member purchase their plan through the FFM or Providence directly?
What is a connect plan?
BONUS: Individual direct
The termination date for MBR ID 100897362-00.
What is 04/01/15?
The department made up of 3 subsections that is responsible for making sure PHP is not paying out more than we need to on claims.
BONUS: Can you list the three sub departments?
What is OFT (Operations Financial Transactions)?
BONUS ANSWER: What is COP, TPL and Refunds
The topic that houses information on infertility benefits.
What is the Pregnancy topic?
The name of the only UC facility located within 5 miles of zip code 97006 for a prospective individual choice member.
What is Providence Medical Group - Tanasbourne Immediate Care?
The definition of Cobra.
What is: Continued coverage for 18 months after their employment has terminated. The member is responsible for the full premium amount and has the same coverage that they had under their employer when they were still employed.
The most recent effective date, group # and group name for MBR ID 100890254-01.
What is 04/01/18, gr 100218 and Multnomah Bar Association?