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Ambetter Olympics

Completar frases

(3)
Practice

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Sobre Completar frases
employee training
training
claims
ambetter health provider
centene
 Edad recomendada: 16 años
22 veces realizada

Creada por

Fabiola Nunez
Fabiola Nunez
Estados Unidos

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Ambetter Olympics

Practice

Fabiola Nunez
1

reconsideration member claim provider

A is a written communication from the to the health plan about a disagreement in which the was processe d

2

reconsideratio dispute

A is a written communication from the provider to the health plan about an unsatisfactory decision to a

3

corrected intent correct claim

A claim is a submitted from the provider , in reference to a previously submitted / processed claim with the to a billing erro r

4

clean rejection provider claim correction

If a is rejected , research the reason , advise the provider of the reason , instruct to submit a claim with the

5

member written provide grievance

A is a verbal or expression of dissatisfaction to the health plan by the or

6

properly protected health HIPAA

is the United States Law requiring that information is use and at all times .

7

verify information error HIPAA two

When you release PHI without verifying key pieces of information , this will result in a violation . When you do not release PHI , but neglect to two key pieces of , this will result in a HIPAA .

8

balance payment negative EOP recoupment

A balance happens when a provider was due monetary , but they already have a negative with us . This may be due to a or pre - payment that was made to that provider , either on the same or prior .

9

negative two split between

A check happens when a service line has been spited a balance and a payout , between different payouts , or between a pre - payment and a payout .

10

Pending pend review

claim occurs when Amisys cannot auto adjudicate the claim . The claim will for a claims examiner to and / or processes .

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