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Chapter 3 Team Activity

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