Bravo Marine Heating System Bh 0133 Users Manual
2015-02-02
: Bravo Bravo-Bravo-Marine-Heating-System-Bh-0133-Users-Manual-484987 bravo-bravo-marine-heating-system-bh-0133-users-manual-484987 bravo pdf
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Page Count: 74
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![1 TABLE OF CONTENTS QUICK REFERENCE GUIDE .........................................................................................................................................................4 MEMBER INFORMATION ............................................................................................................................................................ 6 Member Eligibility .................................................................................................................................................................6 Eligibility Verification............................................................................................................................................................6 Member Hold Harmless..........................................................................................................................................................8 Member Confidentiality .........................................................................................................................................................8 Member Rights and Responsibilities ......................................................................................................................................9 Advance Medical Directives...................................................................................................................................................13 Benefits and Services..............................................................................................................................................................13 PROVIDER INFORMATION ..........................................................................................................................................................13 Role of the Primary Care Physician (PCP).............................................................................................................................13 Role of the Specialist Physician .............................................................................................................................................14 Communication between Providers........................................................................................................................................14 Provider Marketing Guidelines...............................................................................................................................................14 PROVIDER CREDENTIALING AND PARTICIPATION ........................................................................................................... 15 PROVIDER & ALLIED HEALTH PRACTITIONERS CREDENTIALING CRITERIA ........................................................ 15 Required Information .............................................................................................................................................................15 Credentials Criteria................................................................................................................................................................. 16 Additional Requirements........................................................................................................................................................19 Initial Credentialing Office Site Reviews...............................................................................................................................19 Provider Re-Credentialing......................................................................................................................................................20 Practitioner’s Rights ...............................................................................................................................................................20 PROVIDERS DESIGNATED AS PRIMARY CARE PHYSICIANS............................................................................................21 CHANGES IN ADMINISTRATIVE, MEDICAL AND/OR REIMBURSEMENT POLICIES..................................................21 NOTIFICATION REQUIREMENTS FOR PROVIDERS............................................................................................................. 21 CLOSING PATIENT PANELS......................................................................................................................................................... 22 PROVIDER ACCESS AND AVAILABILITY STANDARDS ....................................................................................................... 22 CLAIMS SUBMISSION ................................................................................................................................................................... 23 Professional Claims ................................................................................................................................................................23 Institutional Claims.................................................................................................................................................................24 Participating Provider Claim Reconsideration Process .......................................................................................................... 25 Claim Adjustment Reason Codes ...........................................................................................................................................26 NATIONAL PROVIDER IDENTIFIER (NPI)................................................................................................................................ 31 HIERARCHICAL CONDITION CATEGORIES (HCC) .............................................................................................................. 33 SAMPLE EXPLANATION OF BENEFITS (EOB) STATEMENT AND PAYMENT CHECK ................................................34](https://usermanual.wiki/Bravo/BravoBravoMarineHeatingSystemBh0133UsersManual484987.1987356399-User-Guide-Page-2.png)
: Bravo Bravo-Bravo-Marine-Heating-System-Bh-0133-Users-Manual-484987 bravo-bravo-marine-heating-system-bh-0133-users-manual-484987 bravo pdf
Open the PDF directly: View PDF
Page Count: 74