NSHD Crossword Puzzle
Across
- 7. this KBA is used to submit an inquiry about the IDR process that isn’t related to any other IDR complaint category
- 10. if required fields aren’t completed on an Unlisted IDR Inquiry complaint, the complaint should not be escalated to _____________.
- 11. The open negotiation period must last ____ business days.
- 13. new bulk provider complaints go to the ____________ queue to be reviewed.
- 14. a type of complaint can be made against the provider or healthcare facility that does not post information about surprise billing in office or on their website
- 18. When a provider asks a complex question about the IDR process, direct them to
Down
- 1. providers should submit this in regards to payment dispute(s) where an issuer or plan is not complying with the decision from the IDRE
- 2. multiple claims under same insurance company/plan, same plan type and from same state where provider believes the issuer or insurance company isn’t complying with the IDR process
- 3. total number of documents needed for NSA Complaint-IDR Fee Collection
- 4. dispute resolution process, which providers (including air ambulance providers), Outofnetwork Emergency facilities, health plans and issuers can use the IDR process to resolve payment disputes for certain ________ charges.
- 5. them to
- 6. public disclosure of patient protections can be submitted _____________
- 8. evidence of what was sent to the plan/issuer can be provided if an EOP/_________ was never received for an Unlisted IDR Inquiry complaint
- 9. the plan, issuer, or carrier must send an Initial payment or _________ of payment no later than 30 Calendar days after a clean claim is received.
- 12. the front and back of this card is needed for most IDR complaints
- 15. the insurance company/plan and the _______must pay the administrative fee
- 16. Surprises Act These disclosures are intended to help give individuals a clear understanding of their protections under the balance billing provisions of the ____________ and who to contact if they believe those protections have been violated.
- 17. The group that makes a decision in an IDR case would be the ______.