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Job Expectations Knowledge Check

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Provider Authorization Knowledge Check

Created by

Randi Weeks
Randi Weeks
United States

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Job Expectations Knowledge Check
 

Job Expectations Knowledge CheckOnline version

Provider Authorization Knowledge Check

by Randi Weeks
1

What is the primary focus of a Provider Services Representative?

2

True or False: Provider Services Representatives are expected to advocate for patients during calls

3

Which of the following is NOT a core duty of a Provider Services Representative?

4

Why must scripts be read verbatim when quoting benefits?

5

What should you do if a provider asks for clarification on a benefit script?

6

True or False: After-call work should be completed in DND mode whenever possible

7

Which of the following is an example of precise, professional language?

8

Which extension handles authorization-related calls?

9

True or False: All benefit calls should be transferred to THG regardless of the service type

10

What is the main reason authorization calls are handled in-house?

11

What are the two types of authorizations reviewed by the Care Management team?

12

True or False: Approval from Care Management guarantees payment of benefits.

13

What should you do if a provider calls to request a retroactive review?

14

Which of the following behaviors should be avoided during provider calls?

15

What must be included in every call log? (Select all that apply)

Choose one or more answers

16

True or False: Provider Services Representatives should use casual phrasing to build rapport.

17

What is the purpose of the Pre-D process?

18

Which of the following services require Pre-Determination? (Select all that apply)

Choose one or more answers

19

What is the fax number for sending clinical documentation to Care Management?

20

What should you do before submitting a new referral in NE360?

 
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