Show:
Auth Requirements
IBAAG
ABREVIATIONS
DEFFINITIONS
ABREVIATIONS CONTINUED
100
What is the name of the document where Auth Requirments are found
What is Notification Gateway Tool (NGT)
100
What are 3 ways to search in IBAAG?
What is Control F, Drop down list, and Quick Search ICONS.
100
COB
What is Coordination of Benefits
100
___________is the location of medical/surgical services rendered, such as physician's office, hospital outpatient department or emergency room.
What is Place of Service
100
DOB
What is Date of Birth
200
What is the name of the system that houses authorizations before 11/01/2011
What is Care One.
200
What terminology under "Medicare-Covered Visit at Primary Care Physician’s Office" in IBAAG signifies that surgery is covered if done in the office?
What is Medically-necessary medical or surgical services furnished in a physician’s office.
200
HMO
What is Health Maintance Organization
200
The _________is the amount we will consider after all non-covered amounts have been subtracted.
What is Allowable Expense
200
SSN
What is Social Security Number
300
What number is the History tab in ICUE?
What is 8.
300
Under the Preventative Service heading in IBAAG how many different benefits catagories are listed there?
What is 22
300
HIPAA
What is Health Insurance Portability and Accountability Act
300
This is a provider who has contracted with the health plan to deliver medical services to covered persons.
What is Participating Provider
300
M&R PPR
What is Medicare and Retirement Provider Phone Representative
400
Does J0897 require notification?
What is Prior Authorization is only required for Xgeva (J0897). Prior Authorization is not required for the brand name drug Prolia. Please include the National Drug Code (NDC) in addition to the HCPC to distinguish these drugs on the claim.
400
How many benefit periods can a member have?
What is there is no limit to the number of benefit periods you can have.
400
IBAAG
What is Intranet Benefits At A Glance
400
International Classification of Diseases - diagnosis or nature of illness or injury of why a patient is being seen.
What is ICD-9 Code
400
AARP
What is American Association of Retired Persons
500
Provider is calling about a member with an UnitedHealthcare Nursing Home Plan. They want to know if CPT 72125 needs authorization .
What is Excluded from authorization.
500
Please list the Benefits for a Private Duty Nurse at Home under member ID #947152907.
What is this benefit is not covered.
500
ORS
What is Online Routing System
500
_____________is defined as individually identifiable health information that relates to: •The past, present or future health condition of an individual; •Health care provided to the individual; or •Payments of such health care.
What is Protected Health Information
500
IVR
What is Interactive Voice Response