Resource Book
Is a wig made of human hair coverable?
No, only synthetic wigs are coverable.
If the deductible tab only displays a single line that reads "Annual Deductible" this indicates that the deductible is _____.
Combined.
If we are unable to confirm whether a provider is in or out of network, which benefit line should we quote?
Both In Network and Out of Network
Can an EIN be shared by more than one provider?
Yes. All providers who are employed by the same office will all share the same EIN.
What historical event took place in Poland on January 20, 1320?
Duke Wladyslaw Lokietek became king.
What is the TOS code for a Well Baby Exam?
8752
What subject and category will be used to document Out-Of-Pocket accumulations?
Subject: Limits
Category: Limits
Which benefit does an EKG test pay under?
Lab Benefit
Does Pacific Source offer to hold contracts with Groups of Providers?
No, Pacific Source only holds contracts with individual providers or facilities.
On January 20th, 1576, a Mexican city by the name of _____ is founded by order of the viceroy Don Martin Enriquez de Almanza.
León
Which two meanings can be typed shorthand by the acronym "BP"
Blood Pressure
Bright Path
Recite the Deductible & OOP Disclaimer
DED and OOP accumulations are subject to change, and do not account for any claims that are currently processing, subject to reversal, or reconsideration.
What subject and category should be used when quoting information regarding the Prenatal Program?
Subject: Program
Category: Prenatal Program
Can a chiropractor be chosen as a member's PCP?
No, as a chiropractor is a specialist, and is not listed under the Qualified PCP Types and Titles: section on the PCP resource page.
What is the name of the British K-class submarine that sank on January 20, 1921.
HMS K5
Is there a rental period required for the replacement of a CPAP machine?
No, no rental is required.
Does the deductible accumulation always apply to the out-of-pocket maximum?
Not always. Verify through the BSDL.
Are charges for labs billed separately when a member gets a vasectomy?
No, typically labs are billed as included in the procedure.
The First _____ network can be utilized by members in all states besides Oregon, Idaho, Washington, and Montana.
Health
What is the title of the first full-length talking motion picture filmed outdoors and released on January 20th 1929?
In Old Arizona
What is the email address for the team who handles DocuSign documents?
MBRDocs@pacificsource.com
Accumulations towards the deductible and Out-of-Pocket Maximum will always show in the _____ column for a non-embedded plan.
Family
SLIT- sublingual immunotherapy- does not have a specific CPT code. But it is considered I/E/U and not coverable. Information can be found on the Allergy Services Resource Page
In order to verify that we are searching the correct provider: We must verify which 3 pieces of information?
Provider name, NPI, and practice address.
Who became the first female Vice President in the United States on January 20th 2021?
Kamala Harris