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T or f: If I am a non-network, participating provider I don't file your claims.
False
If I am attempting to get permission for a medical service or device, what is that called?
Authorization
What is a DBN?
the 11 digit number on the back of ID cards
What is the dual eligibility Tricare and Medicare wrap around coverage?
TFL
TRR, TFL, TYA are the T-Plans
False, TRR, TRS, TYA
What tool assists to determine if an Auth or Referral is neccessary?
RADS
Which system do we COMPLETE a PCM change in?
Opsconnect but I will also accept DOES
Which plan provides temp coverage as someone is separating from their plan (is allot like COBRA)
CHCBP
Which plan provider temporary coverage for 180 days to help cover an illness or injury as someone leaves the service?
TAMP
Which tool do you view your sched in?
Verint
which tool is used for locating civilian providers?
Provider Directory
What system is the system you will take calls with?
Amazon Connect
What is a cold transfer?
When you transfer someone to another line without introducing them first
What is a warm transfer?
When you transfer someone, but you go with them to introduce them to the new agent before dropping off.
How long does a provider have to submit a claim?
90 days
How long does a claim have to Reprocess?
45 days
