Member
Provider
Name That Policy
Systems
100

112516995

Who is Abel Wilson 6/9/1999

100

This is how you make a note the provider is In Network

What is INN?
What is Par?

100

115239800

What is NE Medicaid 

100

This system is where we begin and end all calls

What is Facets?

200

Dakota Wilson 7/25/2000

Who is 111891249

200

This number can be used to look up a provider, it can also be called an Employer Identification Number

What is a TIN?

200

111630417

What is KS DSNP

200

This system is used to find SOP's and Job Aids

What is Knowledge Central

300

6402516465

Who is Dana Wilson 04/09/1988

300
Use this if the provider is not pulling by the NPI or TIN. 

What is UNKNOWN?

300

111399888

What is WI Medicaid
300

This system tells us how to creat an authorization

What is the Auth Entry Grid?

400

05097243401 has two policies, this one is her Medicaid policy

What is 111855213?

400

This SOP gives instructions on how a proider can request a PCP change for a member

What is Provider Lookup PCP Change SOP

400

00101448654

What is KS DSNP

400

These systems are used to check if a code requires auth and if there are any state specific call outs

What are EPAL SSG & PNL?

500

Roxann Willimas 04/30/1974, there is something special about this memeber

What is a lock in status?

500

This Job aid is used when a Provider is upset that benefits were misquoted

What is the Call Handling Onesource/Misquoted Benefits Job Aid?

500

1440878013

What is WI DSNP

500

This system is used to verify if a code is valid and billiable

What is Knowledge Library?