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15
×
How long is an EOC timeframe for am ADSM?
6 months
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15
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Which Article in the Knowledge Base goes over helping providers with an auth/referral in Availity?
1327
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15
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Which health plans do not require a referral?
Tricare Select and all other PPo type plans
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15
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Scenerio: An ADFM does not get a referral, do they have to pay for that appointment out of pocket?
Point Of Service
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15
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What two factors contribute to how long a referral lasts?
EOC Timeframe and Visit count
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15
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How long is an EOC timeframe for anyone Other than an ADSM?
365 days
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15
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Scenario: An ADSM does not get a referral, do they have to pay for that appointment out of pocket?
Yes
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banana
Go to last place!
Oops!
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star
Double points!
Okay!
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rocket
Go to first place!
Okay!
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lifesaver
Give 25 points!
Oops!
15
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Which FAQ document helps with the path to walk a bene to a referral or auth in their Bene portal?
1092
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seesaw
Swap points!
Oops!
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star
Double points!
Okay!
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shark
Other team loses 20 points!
Okay!
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baam
Lose 25 points!
Oops!
15
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What is Continuity of Care?
allowing the patient to have an ongoing relationship with their provider despite changes
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15
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Which health Plans Require a Referral?
Tricare Prime, TPR, TPRO, TPO
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15
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How do TRICARE referrals and authorizations work with OHI?
Must follow the rules of the OHI first then filter down to TRICARE
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seesaw
Swap points!
Oops!
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star
Double points!
Okay!
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shark
Other team loses 20 points!
Okay!
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banana
Go to last place!
Oops!
15
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Which two tools do we use to check on someone's authorization?
Salesforce First, CareRadius Second
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15
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Which tool do we use to determine if something requires an Authorization?
RADS
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