NSHD Crossword Puzzle 8/2023

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Across
  1. 3. new bulk provider complaints go to the ____________ queue to be reviewed.
  2. 5. 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. 8. providers should submit this in regards to payment dispute(s) where an issuer or plan is not complying with the decision from the IDRE
  4. 10. 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.
  5. 12. the front and back of this card is needed for most IDR complaints
  6. 14. 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.
  7. 16. if required fields aren’t completed on an Unlisted IDR Inquiry complaint, the complaint should not be escalated to _____________.
  8. 17. When a provider asks a complex question about the IDR process, direct them to
Down
  1. 1. This 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
  2. 2. this KBA is used to submit an inquiry about the IDR process that isn’t related to any other IDR complaint category
  3. 4. The open negotiation period must last ____ business days.
  4. 6. evidence of what was sent to the plan/issuer can be provided if an EOP/_________ was never received for an Unlisted IDR Inquiry complaint
  5. 7. 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.
  6. 9. public disclosure of patient protections can be submitted _____________
  7. 11. The group that makes a decision in an IDR DISPUTE would be the ______.
  8. 13. total number of documents needed for NSA Complaint-IDR Fee Collection
  9. 15. the insurance company/plan and the _______must pay the administrative fee