Additional Info
This new title is what we call people who manage a specific practice location
PGM - Practice Group Manager
Name 5 Delegated Payors that are not, Aetna, Cigna, Optum
MediNcrease, Quest Behavioral, Humana, Humana Tricare East, JHHS, Anthem, Carelon, Centivo, Compsych, BHS, PNOA, Partners Direct, Sana.
Every checklist should have a signature, not necessarily your signature at the bottom before adding to committee.
False. If you are adding the provider, the signature should be yours.
First step after getting provider New Hire Email.
Pull License Verification
Rory and Lorelei are two main characters in this Amy Sherman Paladino TV Show
Gilmore Girls
When adding a provider to Availties PDM we should always list the providers Social Security number
FALSE - See a Social Delete a social in AVAILITY!
On the Credentialing flow chart, what two process can be done simultaneously once the CAQH is Created.
Delegated and Local Process
Reviewing the CV is super important to all credentialing. Unless it is a recred.
False. We should always review the CV even if it is a recred. But we do not need to add any info on the checklist when doing so.
Once a provider passes Committee, we should add them to the Optum Portal and what other portal?
Availity
Pittsburg Steelers recently lost to this team in what the NFL is calling the "Snow Globe Bowl"
Stinky Browns
True or False: Aetna excepts Medicare, EAP
FALSE
What two payors can be flipped within 15 days of passing committee
Optum, Sana
A provider with findings. Should have these areas filled out on their Checklist, before committee.
Ad-hoc Unclean Notification Date - Ad-hoc Unclean File Date
- After Committee -
We place the decision in the Committee Decision section.
The Next Team Party is going to be with what three teams
Atlantic, Pacific and North West
We have how many days to get a provider on committee once we pull their CAQH App
30 Days.
The only National Delegated Payor we personal Submit to is
Optum - Through their portal
This payor has a rule that restricts who can be submitted to them based off of the date they completed their education.
Compsych - 3 years from Graduation
The providers license type is listed in this section on the Checklist
Role
If the date and/or source is not populating on the verification, what should we do?
Attach the receipt to the verification before uploading to the verification log.
If you like you should of put a ring on it was sung by this Country Music Artist
Beyonce
All enrollments should have these three things listed when being added
1) Date Sent
2) Date Joined
3) Status
When submitting a demo update, what date should we use for the "Date App sent?"
The date the roster is being sent, or was sent to the roster staff
An ECFMG being listed as a BA is a problem and we should reach out for their highest degree.
False. An ECFMG will always show as BA. That is their highest EDU
Current CEO of LifeStance
Ken Burdick
What is David's Middle Name
William