Claims
This claim form is used for outpatient claims.
What is a 1500 form?
This run screen shows negative balances.
What is CP0700?
The system used to document calls.
What is Omni?
When a provider calls, this is needed to HIPAA verify the provider.
What is the provider's full name and NPI or TIN?
HealthNet & Trillium Medicare Plans are considered this part of Medicare (A, B, C or D).
What is Part C?
When a claim starts with an 'R' instead of a 'Q', it means this.
What is a claim submitted in the year 2018?
Other answers:
R = 2018 claim
Q = 2017 claim
Claim is from 2018, etc.
The information that screen IQ0100 can show you.
What is Member information?
This is the reason that you would not go to Emdeon to fax a copy of the provider's EOP.
What is the provider is set up with electronic deposits?
Provider does not receive paper checks
Provider gets payments from PaySpan
These are the Oregon Market's 3 employee committees.
What are Diversity; Safety; and OCAT?
These are three services covered by Medicare Part A.
What are Inpatient Care, Home Health, and Hospice?
This number is used to describe an emergency admission on the UB04 claim form.
What is the number 1?
This screen shows basic provider information.
What is IQ0200?
The program used to view a rejected claim image.
What is Filenet?
When you wish to log into Emdeon, this is where you go to access the program.
What is SharePoint - Operation Resource Page or your favorites bar?
(Acceptable answers: Resource Page, Operations page, SharePoint, Favorites, bookmark, etc.)
Medicare Part D covers this.
What is Prescriptions?
The term EOP means this.
What is Explanation of Payment?
IQ0880 can show you this.
What is Member Details Inquiry?
This program contains the most information regarding claims and is used to process claims.
What is Amysis?
When you need to go to Cornerstone to take an online training, this is where you go to access Cornerstone.
What is CNET?
The number of HealthNet Medicare plans.
What is 5?
Aqua, Violet 1, Violet 2, Violet 3 and Ruby
This type of provider is unable to appeal a claim.
What is a participating Medicare provider?
Other acceptable answers:
PAR provider
N362 is this date when present on a claim
What is December 28, 2014?
The Program used to view a provider's rejection letter.
What is Emdeon/Change Healthcare?
When you are needing to look up a member's benefits, these are the 2 documents on the public website that are used as a reference.
What are
Summary of Benefits (SOB)
Evidence of Coverage (EOC)?
This is the type of member on the Trillium Advantage health plan.
What is a dual member?
(Member has Medicaid & Medicare; DSNP; OHP member, etc.)