What is the primary function of a National Provider Identifier (NPI)?

It is a unique identifier for healthcare providers

It serves as a billing number for providers

It determine the provider's tax rate for claims

It determines the provider's reimbursement rates

What is the purpose of conducting site visits during the provider enrollment process?

To ensure the provider has a physical location and meets applicable standards

To provide training on Medicaid billing procedures

To evaluate the provider's customer service skills

To collect fingerprints from providers as part of their background checks

What role does the revalidation process play in Provider Enrollment?

It verifies the ongoing compliance and accuracy of provider information

It assesses the provider's eligibility for a performance bonus

It reviews the provider's proficiency in providing healthcare services

It validates the provider's information during initial enrollment

What is the significance of a Medicaid Participation Agreement?

It establishes the terms of the provider's participation in the Medicaid program

To identify providers prohibited from participating in Medicaid programs

It outlines the provider's commitment to organizing healthcare education forums

It signifies the provider's eligibility for a state-sponsored sign-on payment

In the context of Medicaid, what does "CVO" stand for?

Credentialing Verification Organization

Compliance Verification Operations

Community Validation Organization

What distinguishes a billing provider from a servicing provider in Medicaid?

A billing provider submits claims for reimbursement, while a servicing provider handles patient care

The billing provider handles patient care, while the servicing provider manages financial transactions

Both terms are interchangeable, referring to providers with different areas of expertise

Neither of these terms are used in Medicaid to describe a provider

What is the purpose of Medicaid's exclusion screening process?

To identify providers prohibited from participating in Medicaid programs

To highlight providers' achievements in community service

To showcase providers with exceptional patient satisfaction ratings

To identify providers that are preferred to participate in Medicaid

Which of the following is not an exclusionary database typically checked?

OIG List of Excluded Individuals and Entities (LEIE)

SAM (System for Award Management) Database

Medicare and Medicaid Adverse Actions

How many different Medicaid provider categorical risk levels are there?

Risk levels are only used in Medicare

What is a "provider type"?

The distinct classification that indicates the primary services offered by a healthcare provider

The unique identifier assigned to each provider for internal administrative purposes

The distinction between whether a provider is a billing or a servicing provider

The distinction between whether a provider is an individual or a group

The rate at which applications are returned back to the provider

The rate at which applications are returned back to the BPS analyst

The rate at how long it takes to process an application

The rate at which applications are returned back to the client

In the context of Medicaid provider enrollment, what does CLIA certification signify?

Compliance with federal regulations for clinical laboratory testing

Authorization to prescribe controlled substances

Accreditation to provider healthcare related services

Compliance with state regulations for billing claims

How does the inclusion of a DEA number impact the provider enrollment process in Medicaid?

It allows the provider to prescribe controlled substances

It signifies eligibility for government-funded healthcare initiatives

It indicates the provider's proficiency in electronic health record management

It grants permission to provide direct patient care services

Who is the governing board for medical licenses held by healthcare providers?

Respective state licensure boards

Gainwell Provider Enrollment Trivia

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28 Qs

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Gainwell Provider Enrollment Trivia

Quiz

•

Professional Development

•

Professional Development

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Practice Problem

•

Easy

Clayton Kelly

Used 2+ times

FREE Resource

28 questions

Show all answers

MULTIPLE CHOICE QUESTION

10 sec • 1 pt

What holiday takes place on February 14th?

Valentine's Day

St. Patrick's Day

President's Day

Independence Day

MULTIPLE CHOICE QUESTION

10 sec • 1 pt

Who is Gainwell's CEO?

Mark Knickrehm

Mike Connolly

Bill Allison

Colleen Ritchie

Jaffry Mohammed

MULTIPLE CHOICE QUESTION

10 sec • 1 pt

Who is Gainwell's COO?

Mike Connolly

Colleen Ritchie

Mark Knickrehm

Bill Allison

Jaffry Mohammed

MULTIPLE CHOICE QUESTION

20 sec • 1 pt

What space does Gainwell offer Provider Enrollment services in?

Medicaid

Medicare

Medicaid & Medicare

Commercial

Medicaid, Medicare, & Commercial

MULTIPLE CHOICE QUESTION

20 sec • 1 pt

What is the primary MMIS used in Provider Enrollment?

interChange

HealthPAS PEA

AIM

MainFrame

MULTIPLE CHOICE QUESTION

20 sec • 1 pt

What is the primary workflow tool used in Provider Enrollment?

FEITH

Process Manager

ServiceNow

MULTIPLE CHOICE QUESTION

20 sec • 1 pt

What system do providers use to enroll into Medicare?

PECOS

NPPES

interChange

DEA

CLIA

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Gainwell Provider Enrollment Trivia

28 questions

What holiday takes place on February 14th?

Who is Gainwell's CEO?

Who is Gainwell's COO?

What space does Gainwell offer Provider Enrollment services in?

What is the primary MMIS used in Provider Enrollment?

What is the primary workflow tool used in Provider Enrollment?

What system do providers use to enroll into Medicare?

What system issues providers an NPI?

True or False: CMS provides guidance that states Gainwell can bypass screening by relying on screening performed by Medicare.

What is the primary function of a National Provider Identifier (NPI)?

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