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PRC Training Week 2

Horizontales
Constant for Telemedicine Freeman Heart & Vascular Institute Joplin
Admitted to the hospital
GPMS toolbar icon to search for constants
Physicians Assistant or Nurse Practitioner
Procedure Code
Request for claim payment to be reconsidered
Facility Claim form
Provision if determining the coverage order for multiple insurance plans
Web based software for Anthem claims management
Accounts Receivable
Local plan for BCBS providers in Missouri
Agreement term used between provider and insurance plan for claim remittance
Diagnosis Code
Professional service claim form
BCBS that's issues the patients policy
Short for Place of Service
BCBS plan in the state where services were rendered
Patient care through an audio-visual electronic device
Process to determine order in which to file multiple insurance plans
Out of Network Anthem group
Verticales
BCBS plan policy numbers always start with "R"
Identification used for provider credentialing
Patient type seen by the provider/practice or specialty within the past 3 years
Annual amount paid by the patient before insurance starts paying the provider
Face to face time with the provider
Zero dollar payment
Contracted rate of payment negotiated by the provider and insurance payer
Constant for Physician Group of Pittsburg
Refers to a secondary claim sent electronically by Medicare after adjudication
CMS questionnaire to verify Medicare's primary/secondary payer status
Where you can find the GPMS Online User Manual
In GPMS, click here to go back 1 page
GPMS toolbar icon to search for patient accounts