Across
- 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
Down
- 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