Optum Benefits Crossword Puzzle

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Across
  1. 4. Classification of health care service levels by: the type of care given, the number of people serviced and the people providing care. Common types include Inpatient, outpatient and intermediate
  2. 5. Treatment provided in a facility that provides overnight service but do not require acute IP care
  3. 7. Advising caller of copay, deductible, session limit, authorization requirements, penalty, exclusions and claim submission details are item needed in
  4. 10. Treatment considered more intensive than routine outpatient usually service 3 hours per day for 2 or more days a week
  5. 11. Treatment at a facility where patient is admitted for 24 hour room and board care
  6. 14. Refers to set dollar amount that is applied for failure to meet certain benefit requirements such as failure to obtain an authorization
  7. 15. Hospitalization Also known as Day treatment provides facility services up to 20 hours per week and a step up from routine or IOP care
  8. 16. BH provider who provides talk therapy and psychological testing
  9. 18. CPT code used for initial psychiatric diagnostic evaluation visit
  10. 19. CPT Code used for individual therapy visit for 45 mins
Down
  1. 1. a process of review to approve a provider who applies to participate in a health plan
  2. 2. BH Medical doctor who can prescribe medication
  3. 3. Type of BH provider who providers talk therapy such as social work or counseling
  4. 6. Claim form used to submit for reimbursement of facility based services
  5. 8. Rate used to determine oon allowed amount for coverage. Determined by calculating provider zip code license level and cpt code used
  6. 9. This can be given to a member/rep by way of phone, text, email, appointment search & member website
  7. 12. Process in which an agent requests specific details to help identify the caller and determine whether the caller is authorized to receive PHI
  8. 13. a specific request to reverse a denial of coverage pre or post
  9. 17. Claim form used to submit for reimbursement of outpatient provider claims
  10. 18. CPT code used for individual therapy visit for 60 mins