A post service appeal should include at least : _______ ( mention 5 elements )
Name , address, phone number , member id number , claim number , DOS, provider information , what is being appealed , reasons , evidence, completed WOL
Oops!
Check
Okay!
Check
20
A post service appeal may be submitted by
The member / someone with written autorization to take actions on behalf the member
Oops!
Check
Okay!
Check
15
If a post service appeal form is submitted outside of this period of time then when it will be administratively
Denied
Oops!
Check
Okay!
Check
20
The post service appeal can be sent only via email , True or false
False
Oops!
Check
Okay!
Check
15
If one of our members decides to send a post service appeal , it should be sent to
Clover health
Oops!
Check
Okay!
Check
15
A decision about payment for care is called a post service appeal and must be resolved no later than 70 calendar days after the appeal is received. True or false
True
Oops!
Check
Okay!
Check
25
A member reach out complaining about the service he got at his local hospital , clover member service support should
Do a grievance
Oops!
Check
Okay!
Check
15
In order to get a post service appeals a member needs to send a formal letter to clover. True or false
True
Oops!
Check
Okay!
Check
seesaw
Swap points!
Oops!
shark
Other team loses 25 points!
Okay!
fairy
Take points!
5
10
15
20
25
lifesaver
Give 20 points!
Oops!
25
If a provider is calling to make an appeal , you must
Transfer the call to provider services line
Oops!
Check
Okay!
Check
baam
Lose 25 points!
Oops!
rocket
Go to first place!
Okay!
fairy
Take points!
5
10
15
20
25
baam
Lose 20 points!
Oops!
25
In case of a provider disputing payment/denial , what we should do?
