PR Fax Team Review

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Across
  1. 2. A/ Covers hospital services for patient's over 65
  2. 4. Plan does not have a network
  3. 11. A percentage of medical expenses that an insured person must pay
  4. 12. HCPCS code for Orencia
  5. 14. office/ A standalone office
  6. 17. existing / Is no longer since 2012
  7. 18. eligible/ Combo of SNP Medicare and Medicaid
  8. 19. Funded / The employer group does not fund the payment of claims
  9. 21. Opportunity to continue group coverage beyond the term of employment
  10. 22. Covered under more than one policy
Down
  1. 1. Not required by payer, just suggested
  2. 2. Best type of plan
  3. 3. / Requires a TAR
  4. 5. 00003-2187-13
  5. 6. / Determines network status of provider
  6. 7. ID / Determines network status of site
  7. 8. Investigation/ Contact, Verify, Navigate
  8. 9. Hybrid policy that has PPO and HMO similarities
  9. 10. Advantage/ Also known as Part C
  10. 13. / Medicaid program designed for children
  11. 15. pharmacy / Distributes Orencia
  12. 16. funded/ The employer group is funding the payment of claims
  13. 20. Acronym for Affordable Care Act