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Worksheets

Central New Hire

Total questions: 17

Worksheet time: 9mins

Name
Class
Date
1.

What are the two types of Appeals?

a)

Dental and Vision

b)

Administrative and Clinical Appeal

c)

Administrative Appeal / Claims Appeal

d)

Clinical and Central

2.

Use for Anthem CDHP for members.

a)

WCA

b)

WCF

c)

CBS

d)

CIRS

3.

Use to locate transfer phone numbers for members on different LOBs.

a)

Clarity

b)

Member 360

c)

BDS

d)

WCA

4.

Use for investigating ITS claims or out of area claims.

a)

Blue Squared

b)

Check Inquiry

c)

NIC

d)

On Demand

5.

Use for emulating the members on Anthem.com.

a)

CAD Emulator

b)

Help Emulator

c)

Smart Help

d)

Member Emulator

6.

Use to access member eligibility, benefits, claims and you will use on every call.

a)

Solution Central Production

b)

Central System Production

c)

Central Solution

d)

HIPAA Tool

7.

Use to check HIPAA Authorizations.

a)

Member 360

b)

HIPAA Tool

c)

AIM

d)

CIRS

8.

Use to access actual pdf of ID card.

a)

On Demand

b)

BDS

c)

Clarity

d)

Smart Help

9.

Use to verify, authenticate and protect a member's PHI.

a)

On Demand

b)

HIPAA Tool

c)

Solution Central

d)

NIC

10.

Use to look up Pre Certification, Predetermination and Authorizations

a)

Member 360

b)

CIRS

c)

EOC

d)

CPSUI

11.

Used for looking up benefits

a)

COE

b)

EOC

c)

NIC

d)

COB

12.

Used to look up a member's incentives.

a)

Verient

b)

BlueSquared

c)

NextGen

d)

ChipRewards

13.

Used to look up Grievance and Appeals for members.

a)

ChipRewards

b)

NextGen

c)

Actwise (Alegus WCA)

d)

Mainframe (WGS)

14.

Used to put a member phone number on a do not call list.

a)

AIM

b)

Number Check List

c)

CIRS

d)

CPSUI

15.

Used for only certain types of Authorizations.

a)

AIM

b)

Member 360

c)

Solution Central

d)

On Demands

16.

Used to find EOBs and Authorization Letters etc.

a)

Smart Help

b)

On Demand

c)

Clarity

d)

WCF

17.

What song is this a quote from?

“Every time I close my eyes, I thank the Lord that I’ve got you. And you’ve got me too.”

a)

John Legend, “Made To Love”

b)

Daniel Caesar, “Best Part”

c)

Babyface, “Every time I Close My Eyes”

d)

Alicia Keys, “No One”