Phase II

2. what you enter to get into WGS pricing service standalone menu
5. is one thing that cannot be viewed in Distribution Enrollment file on DEI
11. easier place to find EOB's
13. carrier's pursuit of a recovery
15. the requirement to contact the local Plan where services will be performed before being admitted for impatient care
17. where you would look up provider file
19. the percentage of the Plan allowance that member pays for their care

1. where you'd look up letters, medical records ect.
3. Plan___is the amount we use to calculate our payment for certain types of covered services
4. allows the CCR to request assistance from another dept/associate
6. database also found in BSessions
7. __events errors in medical care that are clearly identifiable & preventable
8. __Representative that stands in the shoes of the Member
9. where you can look up codes, brochures, ect
10. __ date(the 3rd,4th &5th positions indicating date the claim was received
12. is disp #4
14. is used to further identify the procedure performed
16. screen is current claims for member in streamline
18. Claim___is used to search for an existing claim