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Random facts
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Finding a member info
Providers
Primacy
100
program we use to look up manually submitted claims
What is Documentum
100
This person can request EOB and the amount of time it takes to arrive.
Who is the authorized individual and 7 - 10 business days?
100
The subscriber to plan r81959546.
Who is Nadine A Furukawa?
100
The provider number for Dennis Murakami.
What is 40386?
100
If children are listed on the plan as dependents then the parent with the earlier birthday (month/ day) is primary.
What is the Birthday Rule?
200
Thank you for calling HMSA Customer Relations, my name is _________ . How can I help you?
What is the proper way to answer a call?
200
This is sent back to the provider in the same envelope as the High Level CTRP info.
What is a claim containing invalid data?
200
The coverage that Sarah A Chang (04/20/1992) has.
What is State Act Med?
200
John Cheung
Who is the provider for NPI 1669577722?
200
Medicare as a Secondary Payer
What is MSP?
300
The address for a provider to receive payments to.
What is the Remittance Address?
300
How a member can submit a OOS service claim.
What is 1.member name 2.diagnosis/condition 3.itemization of services 4.Providers Tax id number then mail claim to HMSA PO Box2970
300
The original effective date for Francisco A Mangoba.
What is 04/01/1998?
300
The provider for k254249, effective date 04/01/2016.
Who is John Jiuliano?
300
This MSP rule states that if all three conditions (patient has Medicare part A or A and B, is actively employed by the group, and the group has 20 or more employees) then the group plan is primary to Medicare.
What is the Medicare due to old age MSP rule?
400
In Assist, the F5 key.
What is the key to pull up the Provider Look up?
400
Effective 1/1/16 tax is convered under these two plans- Medical plan 683 and __________.
What is the Vision rider OEM
400
The current effective date for Susan Ashford (08/11/1941).
What is 01/01/2000?
400
The latest check number and amount from provider J59285.
What is 781825 and $516.09?
400
Subscriber/ Dependent, Longer/Shorter, Active/Inactive.
What is the order of Primacy Rules?
500
The program that allows members to receive benefits outside of their plan area and is indicated by a suitcase on their membership card.
What is the travel program?
500
This is also required for a routine vision exam covered under the HMO medical if the provider is non par blue card provider.
What is HMO AR?
500
The Primary plan number for Beverly L Quon for vision coverage.
What is HMSA R000023374945?
500
The check number and amount from 4/29/14 for provider 40386 for fed.
What is 513368 and 401.98?
500
In this situation, the primary payer if a subscriber had two coverages; BC/BS and Aetna, with the Aetna plan starting in 05/01/2014 and the BC/BS plan starting in 01/01/2005.
What is BC/BS?