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For the following MSCAN and CHIP, you can use this vendor for Vision Care.
What is Opticare.
100
You will always use this system during the authentication process and to document calls.
What is CRM?
100
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When working with an interpretive service, its always good practice to:
Our vendor is
Speak directly to the provider/member rather than the interpreter.
What is Voiance
100
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Within Effective Communication; what type of listening encompasses: saving time, relief of negative emotions and creates an environment where everyone feels safe?
What is Effective listening?
100
180 days from the DOS is the timely filing guidelines for 1st time claims for which health plan(s)?
What is Magnolia Health and CHIP?
200
This Health Plan only covers children from birth to age 19.
What is CHIP?
200
What system do you use to verify member's eligibilty with MS DOM?
What is Medicaid Envision?
200
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Dental Services are covered through Dental Health and Wellness for the following health plans.
What is Magnolia Health and CHIP?
200
It is always good to express this type of emotion with the caller and it is a Quality requirement.
What empathy?
200
The filing guidelines for corrections, reconsiderations, and appeals.
What is 90 days from the date of notification?
300
This Health Plan is contracted with the MS DOM.
What is Magnolia Health and CHIP?
300
We use this system to check if a provider is listed as a Non Par provider.
What is Portico?
300
Member HIPPA verification requires that you verify ____ pieces of indentifying information.
What is (3) three pieces?
300
You cannot __________ disconnect a caller.
What is intentionally?
300
For this health plan you must submit first time claims to PO Box 5040.
What is CHIP?
400
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This health plan provides unlimited office visits and no copays.
What is Magnolia Health MSCAN?
400
All claims are processed and filtered into this system(s).
What is Amysis and CRM?
400
Our Pharmacy prior authorizations go through this vendor.
What is US Script?
400
At the end of your call, you must ______ the actions taken on the call.
What is recap?
400
_________is used for transporting members to and from doctor appointments.
What MTM?
500
Members requiring Behavioral Health services will contact this vendor.
What is Cenpatico?
500
You can view all paper claims and remittance advises processed through this system.
What is the Emdeon?
500
This program allows member to earn incentives for completing healthy behaviors.