NEHP - New England Health Plan
NEHP Small Group Quiz
Test your knowledge on the New England Health Plan (NEHP) for Small Group Policies. This quiz covers a range of topics including plan details, provider networks, and referral requirements.
- Multiple-choice and checkbox questions
- Scoring to track your progress
- Fun way to engage with NEHP information
How many states are under the New England Health Plans for Small Group
10
6
5
20
What 2 prefixes do we have for NEHP SG Access Blue New England?
YGE and ZZG
YGL and YGE
ZXW and XJV
TXH and ZXW
If a member has a NEHP policy but wants to see a provider in Florida, would this be in network?
True
False
Do Access Blue New England plans need referrals for participating providers?
True
False
What system should you use if a member wants to update their pcp and they are NOT in one of the NEHP states
Solution Central
IE3
Mainframe
BDS
For NEHP Small Group plans what is included in SOS
Ambulatory Service Centers
Inpatient Hospital
Outpatient Hospital Visits
Radiology Centers *diagnostic X-rays and Advanced Imaging*
Doctors Office Visits
Authorizations are dictated by the member’s _________ state.
Host plan
Home plan
PCP
Designated Network
Do the Maine NEHP Individual HMO plans need referrals for participating providers
True
False
Does the member's PCP state complete authorizations for behavioral health?
False
True
Where would you locate the pcp ID for one of the NON-NEHP states
SC
Mainframe
Anthem Website
Extract File
What are the SM group HMO referrals called
Direct
Cross-Border Referral/Notification
Continuation of Care
Out of Network/Out of Area Referral
What box number on the CMS 1500 form would you find the referring physicians name
24 A and B
4
21
17 A and B
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