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Customer Advocacy Crossword Puzzle

Across
The name of our Medicare Cost Plans.
Allows a representative to have access to member information, used for SrCare members and remains in effect until withdrawn by member.
A Clearinghouse that SWHP uses to process electronic claims.
The use of video links, email, telephone or another telecommunications system to transmit medical information.
Plans that provides a range of benefits for a set fee. The plan features a list from which to choose your primary care physician.
Down
The amount paid before our plan begins to pay its share of covered medical services, specific benefits, or drugs.
The facilities, providers, and suppliers your health insurer or plan has contracted with to provide health care services.
A list of covered drugs provided by a specific plan.
A request for the Plan to reconsider an adverse (denial) organization determination or coverage determination on service/drug requested or received
Items or services that Scott & White Health Plan does not cover. The member is responsible for paying for excluded items or services.
It's purpose is to provide health care coverage continuity, ensure greater accountability and simplify administrative functions within the health care industry.The requirements for privacy standards that include the transmission of health information in electronic, paper and oral forms are governed by this act.
A stipulated dollar amount established to cover the cost of health care delivered for a person.
Home-ordered equipment needed when ill or injured, which is sturdy enough to be used many times without wearing out. Examples include, but are not limited to, oxygen equipment, wheelchairs, crutches, or blood testing strips for diabetics.
The screen that brings in the rationale for denial from Claim Check into Amisys.