Instead of "okay"
When verifying information (3 answers):
What is: "Is that correct?" "Just to confirm, you said..." "I would like to verify..."
MRR stands for
What is: Medical Records Required
When building a case we should always validate/verify the MD's....(5 Answers)
What is: MD name, NPI/Tax ID, Phone, Fax, Address
What do we call a CPT code that does not show in CPT code list? Where do we connect?
What is: Non Del. Connect to HP.
Caller wants to change a site on a Z status case
What is: Final status, connect to PSU.
When acknowledging the customer (3 answers):
What is: "Thank you." "Absolutely." "Excellent."
These are exceptions to the MRR rule
What is: Medicare, urgent medicaid
True or False:
You should always read the ICD-10 code and description
Member is not pulling up in system and we are unable to create an elig. case for the HP.
What is: Connect to HP to verify benefits/coverage.
This should always be up and open for receiving important messages throughout the day
What is : WEBEX
When you need some more time to move forward (5 answers):
What is:
“That will be just a moment”
“One moment please.”
“Bear with me.”
“I am populating that information.”
“I am submitting that information.”
Members can speak to CR when case is in MRR and they are non-medicare.
What is: FALSE
We must verify both the _____ and ______ when provided a CPT code.
What is: read back CPT code and description
Caller wants to know what their out of pocket will be
What is: connect to HP
What is: ADD
Words to stay away from (7 answers):
What is: "O"
"Thank you for calling eviCore"
"Can I get, lemme have, or may you"
"ok, alrighty, etc."
"Bye bye"
"Honey, sweetie, etc."
"My computer just went down"
True or False: Case is MRR but pending a denial. You can NOT send them to PSU.
What is: FALSE
True or False:
Entering the incorrect fax number is a HIPAA Validation issue.
What is: True
Caller wants to build more than 3 cases.
What is: Connect them to the multi case build team at ext.20124
what is: E (eligibility)
True or false:
We must always verify where the caller is calling from.
What is: True
Caller wants a J code for OSCAR plan
What is: connect them to specialty cue (Chemo 20732)