Test Your Knowledge

2. When we log into ADP we must also immediately log into ____.
5. Flat dollar amount the member must pay for covered services after deductible is met.
10. We call this for help with foreign language speakers.
12. Before assigning an episode we want to make sure it is ____.
13. We would check the ___ tab on the Member Screen to see if there is POA on file.
14. The member will need to get in touch with them to update demographic information.
16. This is the annual amount the member must pay out of pocket until the plan begins to pay.
19. We can verify this with the Pharmacy and/or the Dr’s office along with their name and 3 pieces of member info.
20. This will help you save money but it is NOT a form of insurance.
22. A reject 53 is usually because this was entered incorrectly.
23. If a CD is denied there is the option to ____ that decision.
24. ____ claims have a blue indicator bar.
25. This abbreviation is the same as NCPDP
28. We submit this type of requests for Reject 25, 56, 71.
29. In addition to our notes, we need to add a Problem and ___, for every episode.
30. We submit this type of request for Reject 81 Claim Too Old.

1. ____ permission is only good for one call.
3. When quoting prices to members, we always advise them that the price is an ____.
4. This is one of the Basic 5.
5. In Transaction Lookup/Paid Lookup we select “Send to ____” to run a test claim.
6. We use this system to check the status of a Coverage Determination
7. Envision Employee Member IDs begin with this.
8. We can create episodes in this screen in Pharm screens.
9. Card requests are submitted in this screen.
11. We can make demographic changes for this discount card but we do not handle enrollments.
12. Envision does not accept this type of NPI.
15. When we see this, it means that we are viewing a DMR claim.
17. This is the Professional Service Code in the Pharmacy’s screen.
18. We do not handle calls from this group type.
21. We select this button to initiate a CD.
26. We must verify this with every call
27. When submitting a card request for commercial members we enter the ____ date in the Card Date Field.