Dental
Three categories dental work is categorized into
What is basic, major, and ortho?
Document you use to provide claiming criteria
What is the Service Code Reference Manual?
What is a Drug Identification Number?
Organization that determines eligible items for Health Spending Accounts?
What is the Canada Revenue Agency?
System used to log into work?
What is Workday?
How long is 1 unit of time (ex. scaling, root planing)
What is 15 minutes?
What are practitioner services?
BlueRX, Provincial, All Drugs
What is a formulary?
Function of Member Profile that allows a husband/wife/partner to have their own password
What is a Spouse Web Account?
Asking a member for their name and date of birth (postal code if a dependent)
What is authenticating?
Proper name for baby teeth
What are primary teeth?
If a member is involved in a car accident, what party is found liable?
What is ICBC?
The name for medication pre-authorizations
What is a Drug Exception?
Page in eInquiry you would click on to view HSA information (Not claims related)
What is Plan Year Balance?
Document on PBCU that contains updates and changes CSRs need to be aware of
What is the Weekly Bulletin?
The biting edge
What is an occlusal surface?
Reference Drug Prices are calculated based on?
What is Day Supply?
The type of method where claims unpaid in a year can be paid with credits from the following year
What is Claims Carry Forward method?
When a member is covered under multiple insurance plans
What is Dual Coverage?
To determine if claims and pre-determinations meet specific criteria set by PBC for eligibility
What is a Consultant Review?
The type of OOC coverage you have if eInquiry displays beyond "Multi-plan"
What is deluxe coverage?
What is a vacation supply?
30, 60, or 90 days from the end of an HSA benefit period
What is a run off period?
Process where an eClaim is flagged and needs a picture of invoice uploaded or mailed in
What is Receipt Verification?