The Final Review Quiz

What is an authorization ?

• An agreement between Amerigroup and a provider that a specific service for a specific member is medically necessary. Authorizations have a beginning and an end date.

• is an authorization from a member’s PCP to obtain services from a specialist or facility. It is not an authorization issued by Amerigroup.

• Generated by Compass at the start of every authorization request but only released to the provider when an authorization request has been completed and approved

• Process by which medical necessity criteria are applied to assure that proposed care is medically necessary and performed at the appropriate level of care.

who is the coolest trainer ?

• Kaylee

• Michael

• No one

• i hate it here

Where do we look to check a members enrollment status?

• Enrollment

• Additional Actions

• Policy/ Plans

• Update Enrollment

What resource do we use to find the phone number for another department?

• research

• HIPAA V&A tool

• OE CHAT

• contact list

What is the AGP ID ?

• Social

• Anthem Provider ID

• National Payer ID

• Tax ID number

How many things do you have to verify for HIPAA for a provider?

• 3

• 2

• 1

• 4

Who do you say your closing survey too?

• Provider

• Member and Provider

• Member only

• provider only

What add task do we use in compass to check authorization status?

• Additional Actions

• Auth/Benefit Requirements

• Authorization Search

• Recent Interactions

Who is the vendor for pharmacy?

• Carelon RX

• Pharm Con

• Express Scripts

• We dont have one

Which of the following can you not substitute doing HIPAA?

• DOB

• Social

• name

• Member ID number