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Vitals
Knowledge
Checks & Balances
Full
Avengers Trivia
100
These are the two screens you will use to locate Provider information in HRP (from the main web page after logging into the system).
What are the Practitioner and Supplier screens?
100
The Affordable Care Act mandates a standard package of benefits coverage known as this.
What is EHB or Essential Health Benefits?
100
This is where a claim starts.
What is when one of our members receives healthcare services.
100
The G+ Adapter software is managed through your computer which is how you will manage these four things.
What is: 1) incoming calls; 2) making outbound calls; 3) transfer calls; and, 4) chat?
100
This is the name of the character responsible for bringing The Avengers together.
Who is Nick Fury?
200
Provider information can be updated directly by the Provider through these two methods.
What is through NaviNet or by phone?
200
Providers that have proven their billing and clinical reviews to be excellent with Aetna offer the lowest cost to the member and are considered what Tier?
What is Tier 1 Providers?
200
Aetna receives claims in these two ways.
What is paper (hard copy manually entered into the system) or electronically (system receives data without manual intervention)?
200
You log into the G+ Adapter software through the Salesforce system by accessing this link after logging into Salesforce and entering your username and password for the G+ Adapter software.
What is the phone link on the lower left side of the Salesforce screen?
200
This Avenger is the only non-human.
Who is Thor?
300
These are the three ways members can sign up for health plan benefits with Aetna.
What are on-exchange, off-exchange, and Innovation Health?
300
Consumer Business only provides coordination of benefits (COB) for which other plans?
What is Medicare?
300
Providers use these two claim forms for medical services.
What are CMS 1500 and UB-04?
300
As soon as your status is set to "Ready" on the voice channel, you are ready to start receiving calls. When you receive a call, the image to the right will populate on your screen which does this automatically.
What is connects the CSR with the caller?
300
The Avengers comes from this legendary comic studio.
What is Marvel?
400
Consumers who choose to enroll in off-exchange plans should use this website and enter this information.
What is https://healthinsurance.aetna.com and enter their first name and zip code?
400
On the General tab of the Practitioner screen, this section shows if the Provider is "in" or "out of" network.
What is the Benefit Networks section?
400
Consumers can send Aetna a claim form when they pay for services themselves. This is the site they use to find the correct form to submit.
What is www.aetna.com?
400
Transferred calls are either announced or unannounced. This is the difference between the two.
What is a Cold Transfer which is an unannounced transfer, it is transferred without third party or internal department information and Warm Transfer which is an announced transfer, the CSR speaks with the other party prior to transferring the caller?
400
Captain America's real name is this.
Who is Steve Rogers?
500
This is the tab in HRP that will display a member's benefit plan information.
What is the Benefit Plans tab?
500
You can search for a hospital by city or state in HRP by using this tab of the Supplier search window.
What is the Advanced tab?
500
These four pieces of information make searching for a claim much easier.
What is: 1) the date of service; 2) total charge (billed) amount; 3) Provider of service; 4) type of service performed?
500
You can change your status in the G+ Adapter. You can also hover your mouse over the status to see more details. When you change your status, you will be choosing from a list of what is know as this.
What is "states" (e.g. ready, not ready, not ready-break, not ready-lunch, etc.)?
500
In this universe, the acronym S.H.I.E.L.D. stands for Strategic ______ Intervention, Enforcement and Logistics Division.
What is Homeland?