GNMS: Wk3_Day3_AM Review

We might use a National Provider Identifier (NPI) number to . . .

Choose all that apply.

• To find a member’s policy

• To help a member determine if their provider is in network or out of network

• To determine if a provider has a contract with BCBS

• To determine if a member is authorized to see a specific provider

Which of the following apply to a Primary Care Physician? Choose all that apply.

• Family and general practitioners

• Internists and pediatricians

• Specific medical focus

• Provides referrals to specialists

A member can use ​ (a)   to find a provider.

• Blue Access for Members
• ProcedureFlow
• ACE
• Provider Finder
• Member Inquiry

An in-network provider has a higher​ (a)   and (b)   balance bill.

• benefit level
• cannot
• can
• deductible
• maximum

When verifying if a provider is within a member’s network, a ​ (a)   must be completed within ​ (b)   business day(s)?

• Response Protocol Letter
• one
• Provider Request
• two

The​ (a)   system allows you to generate and complete a Service Center standardized letter or form.

• Scribe
• ProcedureFlow
• CMMouse
• Emulators