Module 2- Providers Assessment
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What network code is the ADDP Dental Network?
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99
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16
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25
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35
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This quiz evaluates knowledge on the ADDP Dental Network, identifying Star designated providers, claim submission enhancements, and provider participation specifics.
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- 2.
How will you be able to tell Star designated providers through Find a Dentist?
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A Star will appear beside their name
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They will appear at the top of the results list
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They will not be shown differently than other particpating providers within the ADDP Dental Network
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A Star will show beside their name and the Star designated providers will appear at the top of the find a dentist list
Correct Answer
A. A Star will show beside their name and the Star designated providers will appear at the top of the find a dentist listExplanation
Star designated providers can be identified in two ways: a star will show beside their name and they will appear at the top of the find a dentist list. This means that they will be visually distinguished with a star symbol next to their name and they will also be prioritized at the top of the list, making it easier for users to identify and choose them.Rate this question:
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- 3.
When making an appointment for a referral for an ADSM with a provider's office, we should advise the office they can now file their claims through the referral modification screen in DART Plus.
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Yes
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No
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Only mention this if the office asks you about DART enhancements
Correct Answer
A. YesExplanation
The given statement suggests that when making an appointment for a referral for an ADSM with a provider's office, we should inform the office that they can now file their claims through the referral modification screen in DART Plus. This implies that it is important to communicate this information to the office so that they are aware of the new process for filing claims.Rate this question:
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- 4.
What are the ways a provider's office can request an appointment control number?
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Through the IVR
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From the website
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By talking to a representative within ADDP
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All of the above
Correct Answer
A. All of the aboveExplanation
All of the above options are ways in which a provider's office can request an appointment control number. They can request it through the Interactive Voice Response (IVR) system, by accessing the website, or by speaking to a representative within ADDP.Rate this question:
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- 5.
How can a provider submit a claim to ADDP with the new enhancements?
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In DART by going into a referral or authorization
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By Speed eClaim
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By mail
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Electronically
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All of the above
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B, C and D
Correct Answer
A. All of the aboveExplanation
The provider can submit a claim to ADDP with the new enhancements through various methods. They can submit it through DART by going into a referral or authorization, by using Speed eClaim, by mailing the claim, or by submitting it electronically. Therefore, the correct answer is "All of the above."Rate this question:
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- 6.
Can a provider that is not particpating with other United Concorida networks become participating with only the ADDP Dental Network?
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Yes
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No
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No, they must also become particpating with the National Fee for Service Fee Schedule
Correct Answer
A. YesExplanation
It is possible for a provider that is not participating with other United Concordia networks to become participating with only the ADDP Dental Network.Rate this question:
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- 7.
What must an office do to maintain their Star designation status within the ADDP Dental Network?
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Submit at least 90% of their ADDP claims electronically
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Submit authorizations electronically via DART
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Receive their United Concordia claims payments via EFT (Electronic Funds Transfer)
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All of the above
Correct Answer
A. All of the aboveExplanation
To maintain their Star designation status within the ADDP Dental Network, an office must submit at least 90% of their ADDP claims electronically, submit authorizations electronically via DART, and receive their United Concordia claims payments via EFT (Electronic Funds Transfer). This means that all of the options listed must be done by the office in order to maintain their Star designation status.Rate this question:
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- 8.
Providers within the ADDP Dental Network that have a Star designation will have a different fee schedule than providers that are just participating with the ADDP Dental Network.
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True
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False
Correct Answer
A. FalseExplanation
Providers within the ADDP Dental Network that have a Star designation will NOT have a different fee schedule than providers that are just participating with the ADDP Dental Network.Rate this question:
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- 9.
In order for a provider to submit a claim through a referral or authorization in DART, at least one line on the referral has to be open or the authorization must have at least one line that has DSPOC Approval and a line status of open.
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True
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False
Correct Answer
A. TrueExplanation
To submit a claim through a referral or authorization in DART, it is necessary for at least one line on the referral to be open or for the authorization to have at least one line with DSPOC Approval and a line status of open. This means that there needs to be an active and valid referral or authorization in place for the claim to be processed successfully.Rate this question:
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- 10.
A Star designated provider has a higher fee schedule allowance for procedures than a provider who is participating with the ADDP Dental Network only.
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True
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False
Correct Answer
A. FalseExplanation
A Star designated provider does not have a higher fee schedule allowance for procedures compared to a provider who is participating with the ADDP Dental Network only. This means that the statement is false.Rate this question:
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- 11.
Star designated providers must receive their payments for claims via EFT (electronic funds transfer)?
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True
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False
Correct Answer
A. TrueExplanation
Star designated providers are required to receive their payments for claims via electronic funds transfer (EFT). This means that they cannot receive payments through other methods such as checks or cash. EFT is a secure and efficient way to transfer funds electronically, ensuring that the payments are received by the providers in a timely manner. By mandating EFT for star designated providers, it helps streamline the payment process and reduces the risk of errors or delays in payment.Rate this question:
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- 12.
If a dental office performs restorations but does not do amalgam fillings in their office they can still be a Star designated provider.
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Yes
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No
Correct Answer
A. NoExplanation
One of the requirements of being a Star designated provider is the office must do amalgams in their office if their office performs restorations.Rate this question:
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Current Version
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Mar 05, 2024Quiz Edited by
ProProfs Editorial Team -
May 19, 2014Quiz Created by
Courtney Dickinson
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