UHC Questions
SOP Question
NCC Quesitons
Getting to Know the Team
100

What tool should you check to identify potential duplicate MPINs for a provider?

Provider Console / OPERA AI

100

If outreach was made for information, but no response was received and the file must be placed into a 505 status, what should the 253 date be?

The 253 date should be today's date, which is the same date the 505 status is applied.

 

100

What fields must be completed in the Information Request section of the Education PSV Letter?

The following fields must be completed:

  • Last 4 digits of the SSN
  • Date of Birth (DOB)
  • Specialty
100

Name the advocate on our team who recently celebrated 20 years of service with UHC.

Brian

200

Why are thorough NDB notes critical during the credentialing process?

NDB is often the primary source of information for other departments that do not have access to Salesforce Lightning, so detailed notes help ensure accurate communication about a provider's credentialing status.

200

In NDB on the ISZ screen, what expiration date should be entered for an MD or DO with a lifetime board certification?

12/31/2999

200

Which field in Salesforce Lightning (SFL) corresponds to the 253 code in NDB to ensure the information is accurate and aligned between both systems?

The Complete Application Received Date field in Salesforce Lightning (SFL).

200

Which team member earned the Employee of the Month recognition in August?

Abigail

300

According to the Daily Inventory Report email, what is the order of priority when working your inventory?

1. Outreaches Received,405’s, and Answered VSMEs

2. Stalled/At Risk Follow Ups & Aged Impacts

3. Aged PSV01s

4. Priority Records

5. 505 Errors Tab

300

What are 3 states that accept the CDR credential as a valid license for nutritionists?

 

 Arizona, California, Colorado, Michigan, New Jersey, Virginia, and Washington.

300

When working an INI, if a provider's work history contains gaps or does not extend back five years, where can you look to find additional employment history?

 


Review the provider's work gap explanations, Curriculum Vitae (CV), and dates of completed education. You can also check:

  • Replica App
  • CC Notes & Attachments
  • DataSpring_CAQH
300

Which advocate is the only team member on the huddle agenda whose task list does not include recredentialing work?

Zannetta


400

What are the two Flex categories that should be used in IEX?

  • Adjusted Out Open Time
  • Adjusted In Open Time
400

A Florida (all-products) credentialing request required outreach for a DEA and Medicaid ID. The DEA was received today, but the provider does not yet have a Medicaid ID. What is the correct 253 date?


The file should be split, and the 253 date would be today's date for the 501 file. 

400

If using the "Copy Source" button on an element, what should you do before marking the item as clean?

Verify that the source link is valid and correct before marking the item as clean.

400

Who is the next team member to celebrate a birthday?

Diamon (12/26)

500

When conducting a self-audit review during huddle time, what OMEGA status should you be in?

You should be in Exception Time – Meeting/Huddle status while performing your self-audit review during huddle time.


500

When processing a multi-state credentialing file that includes KY EI/MR/C&S and PA EI and all requirements are clean except for the Kentucky Medicaid ID, how should the credentialing cycle be closed?

 The file should be split:

  1. Close KY C&S as 858 – Process Closed – No KY Medicaid ID.
  2. Approve PA (EI) and KY (EI/MR).
500

When is Board Certification verification required for NPs and PAs?

Board Certification is only verified for NPs and PAs when education cannot be verified by another method and the provider reports being board certified. It is not required on recredentialing cycles.

500

Daily Double! 

According to our October edition of the Los Angeles Times, what special day is celebrated on October 21?

 

Back to the Future Day