Final Assessment

Front

What prompts a DMHC Alert?

Back

A California 200C Policy.

Front

If your authorization is missing information, what must you do?

Back

Send the applicable letter.

Front

How long does Anthem have to resolve an exempt grievance?

Back

By the end of the next business day.

Front

Under what approval can a claim be adjusted if the member was referred to an out of network lab by an in network provider?

Back

Associate Empowerment Guidelines.

Front

Where would you click to see the prior inquiries for a member?

Back

Interactions.

Front

What is a DMHC Alert?

Back

A notification related to the Department of Managed Health Care regulations.

Front

What is an exempt grievance?

Back

A grievance that does not require the standard grievance process due to specific criteria.

Tags

CCSS.RI.7.3

CCSS.RI.8.3

CCSS.RI.8.5

CCSS.RI.9-10.3

CCSS.RI.9-10.5

Front

What is the purpose of the Anthem Error Guidelines?

Back

To provide a framework for correcting claims errors.

Front

What does the term 'authorization' refer to in healthcare?

Back

Approval from a health plan for a specific service or treatment.

Front

What is the significance of the 30-day resolution period?

Back

It is the standard timeframe for resolving most grievances.