If a child is covered by both their parents' plans and the mom's birthday is March 2, 1981 and the dad's birthday is April 1, 1974, whose plan will be primary?

If you are covered by your plan at work and your spouse's plan, which plan would be primary?

What are the 3 places where claim information can be found?

What are the 3 pieces of information that we should be asking for to identify the correct claim?

Balance Billing is when an OON provider bills for the difference between the billed amount and the U&C allowed amount

When a provider is OON, the insurance will create it's own (discounted) allowable rate using a U&C algorithm and will only apply the member's benefits to this rate.

An INN provider can bill a member for the difference between the billed amount and the (contracted) allowed amount.

How long do claims take to process?

This document is sent to members to advise them of how a claim processed

Select all of the places of service where a planned surgery might take place

An incorrect Tax ID Number could cause a claim to process OON even if the provider and their billing address were INN

An insurance company might require a(n) _________ to determine what led a member to receiving medical care