Vendors
For outpatient radiology procedures who is vendor used Ascension?
What is National Imaging Associates (NIA).
Which section on the Portal are the provider documents housed?
What is provider resources on must web portals
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Claims forms can be view in this system
What is OMNI or FileNet
What documents are need to submit a claim for reconsiderations?
What is EOP, Reconsideration form and medical documentation necessary for claim payment (medical records).
What document is used to submit an Claim Appeal
What is
For questions regarding symptoms or care for a member's family who would they call?
What is 24-Hour Nurse Advise Line at 1-800-704-1484
Experienced registered nurses are ready to help at anytime.
Where would you go to check procedure codes to see if they require Prior Authorization?
What is Pre-Author Tool on the Ascension Web Portal?
True or False
CenPas is use after you have checked Amisys remarks for claim adjustments or appeals.
What is True.
CenPas is used to view Appeal or adjustment details. Claims analysts reconcile appeals, adjustments and disputes in CenPas.
What is the Payer ID for electronic billing for Vision?
What is 56190?
Which State uses LogistiCare for their Transportation vendor?
What is Ascension Complete Indiana
Ascension Complete uses this vendor for innovative web based solutions for EFTs & ERAs.
What is PaySpan at www.payspanhealth.com
Where would a CSR agent go to give Dental or Vision information Ascension Complete?
What is Envolve People Care or the Ascension Complete Web Portal for that state.
This system is used to view adjudicated claims
What is Amisys?
Claims are processed "Adjudicated" in Amisys
Name the three ways providers can submit claims
What is paper, web portal and electronically
True or False
Members must have referrals to see doctors in network for Ascension Complete
What is False. As long as the provider is in network for Ascension Complete the member can be seen by the physician.
For Transportation Ascension Complete uses these vendors for service?
What is ModivCare & LogistiCare
Each state has a different phone number, check contact list.
True or False
All Prior Authorizations (PA) should accompany a PA form for approval
What is TRUE
These forms are housed on the Portal and they all are not the same PA form.
What information would you retrieve from Emdeon?
What is paper EOPs or Rejected Claim letters
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What is the Medical Payer ID to submit Electronic claims?
What is Payer ID 68069?
What are the three ways a provider can submit an Prior Authorization
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What is Web Portal, Fax (with PA form), or call directly (via agent or IVR)
True or False,
Ascension Complete provides Meals for members based on state eligibility.
What is True,
Some states provide meals for members through GA meals.
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Where would you go to retrieve information for a provider to terminate their contract with Ascension?
What it the timeframe
What is that state's provider manual.
Must allow 60 business days after termination is received and requested.
Credentialing and Network details can be seen in this system.
What is Portico. All provider information is housed in portico.
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What is the timely filing guidelines for Texa claims?
What is
What is the timely filing guidelines for first time claims for Ascension Complete?
What is:
They are different. Initial Claims timely filing may differ based on State Guidelines. Review details in each state's web site provider manual.