Priority Health Individual Markets

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Across
  1. 3. Document that contains criteria, description, coding information, medical necessity review
  2. 5. used to process PH out of state claims
  3. 6. name of PH President
  4. 10. is a global _________
  5. 14. Spectrum Health Now and/or MD Live
  6. 15. amount member pays for covered services before insurance plan starts to pay
  7. 19. Lets your doctor find potential health problems before you feel sick
  8. 20. Credit Card Payment Verification Tool
  9. 21. used to locate member materials
  10. 23. in home and virtual health assessments services
  11. 24. used to house advanced imaging authorizations
  12. 25. Education should always be provided on _____________plans
  13. 26. used to find rewardable procedures
Down
  1. 1. ____ refers to third-party liability claims such as motor vehicle accidents, falls in the house, workers compensation injuries, etc
  2. 2. When taking a call what is the first thing you complete?
  3. 4. Phone and/or video visit with their in-network physician or specialist
  4. 7. Savings Account Manager
  5. 8. flat fee you pay each time you see doctor or get prescription
  6. 9. the member into the queue
  7. 11. an advocate for our member
  8. 12. make sure to always ______ your calls
  9. 13. a member disputes an adverse action made by PH
  10. 16. Health Insurance ________and Accountability Act
  11. 17. Offered at the end of every call
  12. 18. An issue when a member express unhappiness or dissatisfaction
  13. 22. me your priority