Test Your Knowledge

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Across
  1. 2. A reject 53 is usually because this was entered incorrectly.
  2. 3. Envision Employee Member IDs begin with this.
  3. 6. Before assigning an episode we want to make sure it is ____.
  4. 8. We select this to initiate a CD.
  5. 9. When submitting a card request for commercial members we enter the ____ date in the Card Date Field.
  6. 11. This is the annual amount the member must pay out of pocket until the plan begins to pay.
  7. 13. When we see this, it means that we are viewing a DMR claim.
  8. 14. This abbreviation is the same as NCPDP
  9. 15. We submit this type of request for Reject 81 Claim Too Old.
  10. 17. In addition to our notes, we need to add a Problem and ___, for every episode.
  11. 20. We use this system to check the status of a Coverage Determination
  12. 22. Envision does not accept this type of NPI.
  13. 24. This is the Professional Service Code in the Pharmacy’s screen.
  14. 26. Card requests are submitted in this screen.
Down
  1. 1. Flat dollar amount the member must pay for covered services after deductible is met.
  2. 4. ____ permission is only good for one call.
  3. 5. When quoting prices to members, we always advise them that the price is an ____.
  4. 7. We would check the ___ tab on the Member Screen to see if there is POA on file.
  5. 10. We must verify this with every call
  6. 12. This will help you save money but it is NOT a form of insurance.
  7. 16. ____ claims have a blue indicator bar.
  8. 18. We can create episodes in this screen in Pharm screens.
  9. 19. We can verify this with the Pharmacy and/or the Dr’s office along with their name and 3 pieces of member info.
  10. 20. When we log into ADP we must also immediately log into ____.
  11. 21. In Transaction Lookup/Paid Lookup we select “Send to ____” to run a test claim.
  12. 23. We submit this type of requests for Reject 25, 56, 71.
  13. 25. We do not handle calls from this group type.