Quiz 101
NIA Health Plans Knowledge Quiz
Test your knowledge about NIA (TPA) and various health plans with our engaging quiz! This quiz covers a range of topics, including important identifiers, health plan statuses, and crucial tagging processes.
- Multiple-choice and checkbox formats
- Covers various health plans like Cigna and Humana
- Understand key definitions and tagging systems
What are the characteristics of NIA (TPA)? Select all that applies
Do not consent call recording
Usually don’t speak to third parties
Requires clinical review
Peer to peer is always optional
All of the above
What is the tagging for the Identifying IPA task?
Pending+mti+us teams
Pending+follow up with the payer
Pending+npi+pcp referral
pending+npa+other
Luna called evicore, spoke to an intake. She was informed that ordering provider is out of network. Which of the following can she use as push back? Select all that apply.
NPI
Member ID
Address
TIN ID
Refer to the previous question, after using the 3 identifiers, the intake said that the ordering provider is still out of network.What would be her status?
Denied: Other
Denied: Procerdure not Covered
Pending: Needs Practice Attention
Pending: Follow-up with the Payer
Bea called Health Help, spoke to an intake. She was informed that facility is out of network and does not allow out of network authorization. What would be her status?
Denied: Other
Denied: Procerdure not Covered
Pending: Needs Practice Attention
Pending: Follow-up with the Payer
As per TPA, the member has an inactive insurance then upon contacting the health plan, they confirmed that the patient has also no updated policy. What would be the status?
Pending-NPA-Other
Denied-Invalid Insurance
Pending-HFP
T or F: You will proceed on calling the patient if the payer requests you to confirm if they are an active member
True
False
T OR F: In AIM, peer to peer is always optional.
True
False
You can access the portal in Evicore.
True
False
T or F: BCBS,Cigna, Health Help, Aetna and Humana are examples of Health Plan
True
False
Called NIA to identify the precertification required spoke with the intake provided the information was advice that the member is inactive insurance you followed up by asking if they have a updated active policies on file? And intake advice you no updated policy. What would be your status?
Pending+Npa+Other
Pending+Follow up with the payer
Denied+Invalid insurance
None of the above
IPA stands for?
International Phonetic Alphabet
Independent Physician Assistant
Invasive Pulmonary Aspergillosis
Individual Practice Association
How will you tag a task if the payer state to call member?
Pending+NPA+other
Pending+NPA+Clarify the orders
Pending+NPA+Clinical Documentation needed
Pending+NPA+Authorization not found
This workflow is only to be used when the patients name in the task is completely different from attached insurance card?
Member not Found
Out of network
Member name discrepancy
Healthplan
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