RP Forms

Which methods do we have to verify a Responsible Party for a member?

• Macess
  Salesforce
  Biztalk (if medicaid)

• Salesforce only

• Salesforce and Macess

• Salesforce
  Biztalk
  TruCare
  Macess
  MHS
  ePaces
  OnContact
  OnBase

Name all the available and valid Responsible Party forms:

Can we offer to send a Proxy form?

• True

• False

A form that either authorizes Healthfirst to disclose a member’s Protected Healthcare information to a 3rd party or allows an individual to perform certain healthcare activities that involve the member’s PHI:

• HCP

• PHI

• AOR

• POA

A legal document granting an individual authority to make healthcare decisions on the member’s behalf when the member is deemed incapacitated by the attending practitioner. (Physician, nurse practitioner, or physician’s assistant).

• PHI

• HCP

• POA

• AOR

A legal document authorizing another person(s) to act on behalf of a member in private, business, legal or financial affairs, which can also include healthcare billing/payment matters.

• AOR

• HCP

• POA

• PHI

A form authorizing another person(s) to act on behalf of a member to request an exception, appeal, or grievances with Healthfirst.

• AOR

• PHI

• HCP

• POA

Can we assist a member to complete a PHI form?

• True

• False

Which would be the proper way to request a Responsible Party form to be send by email:

• Case Type: Member Support
  Subtype: Document Request
  

• Case Type: Documentation Only
  Subtype: Other Inquiries

• Case Type: Member Support
  Subtype: PHI Request

• No documentation route, email request must be send via correspondence

How long is the estimated time for standard correspondence to arrive?

• 7-10 days

• 4-7 business days

• 7-10 business days

• 4-7 days