My Big Blue Bible

4. The baby is sick and needs to stay in the hospital after the mother’s discharge. This requires a?
8. Participates in network
9. Viewing the IVRPath for validation
10. Stands in the shoes of the member
11. A provision that was enacted on January 1, 1990, to allow Federal employees, retirees, and their family members to temporarily continue their coverage under the FEHBP, after their coverage would otherwise terminate
12. Collection of performance measures to measure effectiveness of healthcare received by members
13. Site to look up key documents
14. is the general term used by the insurance industry to describe situations where the financial responsibility for a Member’s medical expenses rests (in whole or in part) with another carrier.
17. Caused by an external force or element, such as a blow or fall that requires immediate medical attention
18. Covered Adult Preventative Immunization (90662)

1. After hour charges, are considered an adjunct service
2. Can only receive PHI
3. Coding system primarily used to bill Medicare or supplies, materials and injections. Also used to bill certain services and procedures that are not defined in CPT.
5. Anthem Provider Number
6. Provides a list of dental procedure codes, fee schedule and their descriptions
7. Authority must be evaluated each contact
8. four digit code specific to each member
14. Always say this to ensure a positive caller expierience
15. Tracking records of FEP customer service inq.
16. Guidance for enrollment policies and procedures