Customer Service
Give it your best shot!
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How long do we have to process a bill?
Adjustment 8 business days
We can only give the DX codes 9/10 to the provider but not the descriptions
T/F
What is the UB-04 for used to bill for?
Inpatient and outpatient hospital stays
Do we need to authenticate the LLC, in a provider name.
No
What is the script for self service options?
Please keep in mind we do have self service options such as the IVR/WEB PORTAL
How long does it take to process and enrollment application?
5-7 business days from the day submitted.
What is C5 case status?
Case is closed, and bills can be paid within 180 days of it closing
Case updated date = the closure effective date
What is the 1500 for used to bill for?
.... office visits , MRI
What is the process to speak to a family member of the EE/BL program and there is no AREP listed?
What is the hold script?
May I place on you on a brief 1-2 min hold
What is the timeframe for level 2/3 authorizations?
2 - 5-7 Business days
3 - no timeframe
What is needed for you to check eligibility....
If auth is needed or to see if its related?
Case #
DOS
PX
DX
What can be used to filter claims for a claimant?
Case Id
Dummy OWCP id
Claim type
dos / $$
Who can be connected to the MTA line?
Providers for DFEC Program
What is the script about the survey?
Please feel free to take a survey about regarding todays call....
If a provider is terminated - awaiting re-enrollment do they re-enroll or submit a new enrollment app?
New enrollment
C1, C2, C4 are examples of what kind of case status?
Administrative Authorization of Limited Benefits
What is an adjustment?
A change to a bill that previously paid.
What is considered PII?
DOI, DOB, SSN, Tax ID / FEIN, and address
Say a script where you offer assistance and reiterate the reason for their call....
ex I am happy to assist with bill status
ex I understand you are calling for auth status I am happy to help you with that
What is timely filing for a claim?
12/31 of the following year from the DOS.
OR 1 year from the case acceptance date.
Case is open, and authorization is on file.
What would a provider use to navigate denials and next steps?
EOB ref guide
Can we authenticate using a servicing provider OWCP provider ID?
No