What is the purpose of obtaining HIPAA verification during a verbal DOR process?

Appeal Process Flashcard

Flashcard
•
English
•
12th Grade
•
Hard
Quizizz Content
FREE Resource
Student preview

15 questions
Show all answers
1.
FLASHCARD QUESTION
Front
Back
To ensure compliance with privacy regulations and protect patient information.
2.
FLASHCARD QUESTION
Front
What can happen if an appeal is submitted without the required form or if the verbal DOR process is not properly documented?
Back
The appeal may be closed.
3.
FLASHCARD QUESTION
Front
What does 'Pre-Service' refer to in the context of healthcare services?
Back
It refers to the service type before the member had the service.
4.
FLASHCARD QUESTION
Front
If a member's claim is denied as not medically necessary, what type of request is this considered?
Back
An Appeal.
5.
FLASHCARD QUESTION
Front
What is a Clinical appeal?
Back
It involves a denial where clinical review was involved.
6.
FLASHCARD QUESTION
Front
What is the significance of the verbal DOR process in the appeal process?
Back
It is a necessary step to document the appeal and ensure all required information is collected.
7.
FLASHCARD QUESTION
Front
What does DOR stand for in the context of appeals?
Back
DOR stands for 'Denial of Request'.
Create a free account and access millions of resources
Similar Resources on Wayground
13 questions
Unit 1 What's Next? vocab

Flashcard
•
KG - 12th Grade
10 questions
Logos, Ethos, Ethos

Flashcard
•
11th - 12th Grade
10 questions
Ethos Pathos and Logos

Flashcard
•
11th Grade
15 questions
BACE 2.5-2.9

Flashcard
•
12th Grade
15 questions
Appeal Process Flashcard

Flashcard
•
12th Grade
15 questions
Appeal Process Flashcard

Flashcard
•
12th Grade
13 questions
Ethos, Pathos, Logos Practice

Flashcard
•
12th Grade
15 questions
Appeal Process Flashcard

Flashcard
•
12th Grade
Popular Resources on Wayground
25 questions
Equations of Circles

Quiz
•
10th - 11th Grade
30 questions
Week 5 Memory Builder 1 (Multiplication and Division Facts)

Quiz
•
9th Grade
33 questions
Unit 3 Summative - Summer School: Immune System

Quiz
•
10th Grade
10 questions
Writing and Identifying Ratios Practice

Quiz
•
5th - 6th Grade
36 questions
Prime and Composite Numbers

Quiz
•
5th Grade
14 questions
Exterior and Interior angles of Polygons

Quiz
•
8th Grade
37 questions
Camp Re-cap Week 1 (no regression)

Quiz
•
9th - 12th Grade
46 questions
Biology Semester 1 Review

Quiz
•
10th Grade