Review

YES or NO. Assuming the patient date of birth and member ID are correct. The policy show Victor James Smith but the provider only gave James Smith. Is it okay to pass HIPAA?

• YES

• NO

YES or NO . Assuming the patient date of birth and member ID are correct. The provider gave Kensman Smith but the policy shows Kenneth Smith. Is it okay to pass HIPAA?

• YES

• NO

YES or No. Assuming the patient date of birth and member ID are correct. The provider gave Karen Smith but the policy shows Karren Smith. Is it okay to pass HIPAA?

• YES

• NO

What does HIPAA stands for?

• Healthcare Individual Accountability Portability Act

• Healthcare Individual Accountability Productivity Act

• Healthcare Insurance Portability and Accountability Act

• Healthcare Individual Accounting Portability Act

Given the system and application, identify the purpose/function - WGS JAA SharePoint

• Main resource, houses workflows, processes and files related to the line of business

• To view claim forms/medical records

• Primary system used to document calls, view benefits and claims

• To view/reissue/stop checks

Given the system and application, identify the purpose/function - ASPEN

• Pre-certification requirements / exclusions / additional info

• To verify if PHI can be released

• Groups list/updates/workflows

• Primary system used to document calls, view benefits and claims

Given the system and application, identify the purpose/function - Member360

• Pre-certification requirements / exclusions / additional info

• Primary system used to document calls, view benefits and claims

• To view the status of authorizations submitted if approved or denied

• To view EOB vouchers and letters

Please indicate whether the following statement is true or false: JAA policies follow Anthem medical policies and guidelines.

• TRUE

• FALSE

Assuming the patient date of birth and member ID are correct. The member’s name in our system shows Meghan. The provider states the correct name but they spell it out as M-e-g-a-n. Is it okay to pass HIPAA?

• YES

• NO

Assuming the date of birth and member ID are correct. The provider states the member’s first name is Becky. Our system shows the member’s first name as Rebecca. Is it okay to pass HIPAA?

• YES

• NO