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Chapter 3 Team Activity

Across
to verify a provider's credentials are valid, active, and unrestricted
Healthcare services provided at the end of life
requires provider to treat members no differently
may conduct primary verification of a physician’s credentials
A hospital that provides care to only certain types of patients
a legal entity consisting of more than one type of provider to manage a population’s health care and/or contract with a payer organization
a common form of IDS
Consideration for successful network d (2 words)
Category of Ancillary Service
type of hospital-based physician
The process of checking physician minimum requirements by checking training, current certifications, and licensure.
Down
A concept once thought to be the future of the healthcare sector (2 words)
Between payers and providers
specific geographic area in which a payer may sell certain (2 words) products and services
Basic element of credentialing (2 words)
certain contract terms and specifics are subject to periodic change
A claim that has been processed and not held until more info is submitted and has not been rejected because the claim form was not correctly filled out.
Basic element of credentialing (2 words)
Category of Ancillary Service
clause which prohibits the provider from billing the member even if the fee is not paid (2 words)
may conduct primary verification of a physician’s credentials
10-digit number that is unique and never ending
May block hospital consolidations