MISCELLANEOUS
What hospital is PacfificSource partnered with?
What benefit would you quote for cpt 93925?
Duplex Scan
Where would you find online customer service resource pages and information that Courtney creates about COVID-19>
Sharepoint
Is VOYMT/OR/WA/ID a Tier 1 contract for Billings Clinic members?
No, VOYMT is Tier 2
What fax number do provider send their notification of admission if the member is moving inpatient from outpatient?
541-225-3702
Does an Exchange member pay their premiums to the Exchange or to PacificSource?
PacificSource
Is the Willow breast pump covered?
Yes
Who is the provider service representative for Columbia and Washington counties?
Lisa Hess
What network is considered Tier 2 for the Oregon Health Resources group
Smartchoice
What department has a team called Special Functions?
Health Services
Do we offer individual dental policies?
Yes
What first to you need to ask before quoting injection benefits?
Place of Service
Who are the OR team leads?
Amanda, Katrina, Lorrie, Darlene, Jess
Coordinated care network
Is custodial care covered for a member who needs to be moved to a facility with skilled nursing?
No
Can a member with type 2 diabetes get their CGM device at the pharmacy?
No, only type 1 diabetics can
Name the 5 formulary drug lists
ODL, MDL, IDL, WDL, PDL/VDL
Can a Navigator member use First Choice in Spokane county?
No
What software does PacificSource use to edit claims?
CES (Clinical editing software)
In facets, where would you locate information about the primary insurance carrier if PacificSource was the secondary carrier?
COB tab
If 6 yr old Timmy needs to get 3 teeth pulled and is recommended to have sedation, what benefit would we quote
Pediatric Dental as Medical
1933
If an individual direct member is moving from Bend to Eugene, can we update their address?
No, we must transfer this caller to ext 2585
Where in your resource page would you look to find information about Q4L?
Tobacco Cessation