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Treatment plans may be required for certain specialty services such as physical therapy, mental health, substance abuse treatment, etc. Providers will ensure their medical documentation has the correct service and diagnoses that refect their claim submissions. Claims Resolution Priority Partners is dedicated to providing timely resolution of claims. When billing codes are updated, providers are required to use appropriate replacement codes for submitted claims. Priority Partners uses code editing software to determine which services are considered part of, incidental to, or inclusive of the primary procedure. Timely fling periods begin from the date of discharge for inpatient services and from date of service for outpatient/physician services. Together, they provide specifc information regarding the review and interpretation of the Priority Partners Remittance Advice. Tus, there may be sections that are not applicable for posting and reconciliation of certain claims. Payee The name and address of the payee as indicated on the submitted claim Check Date The date the check (if any) was prepared. Billed Amount The amount identifed by the provider as a charge for a service or procedure. Charges Above Max The portion of the billed amount that is in excess of the established fee maximum for the procedure. It may represent that portion of the charge above the beneft maximum (and would not be a members liability) and/or the charge for a non-covered procedure (which would be a members liability). Deduct/Copay/ Identifes the members liability for cost-sharing features (deductible, Coinsurance copayment and/ or coinsurance) of the program. Other Insurance Paid The total dollar amount paid by any other insurance carrier or Medicare. Subscriber Liability The dollar amount which the provider may collect from the subscriber. This amount includes any applicable deductible, copayment, coinsurance and charges for non covered services. The allowed amount minus deductible/copayment/coinsurance minus other insurance paid equals the net payable. Remark Code The code number that identifes a message to the provider regarding payment of the claim. Provider Name The name of the provider who provided services for a submitted claim. Line of Business The code indicating in which line of business the patient is a member.

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The entire population is dependent on technology and any cyber attack on the electrical grid would pose a threat to all. Additionally, children below the age of 18, especially below the age of five, the 2018 210 2018 State of Arizona Hazard Mitigation Plan elderly, the immunosuppressed, and those living in poverty may be more vulnerable to chemical, biological, and radiological attacks as they all have biological effects. Those living in poverty and the homeless may be more vulnerable to attacks based on the fact they may reside in high population density areas, and may have inadequate/insufficient housing to shelter in place. Additionally, police and military personnel may be specifically targeted by terrorist organizations. Jurisdictional Losses Jurisdictional loss estimates can vary greatly in a terrorism event based on the magnitude and type of terrorist action. Catastrophic terrorism events will have proportionally catastrophic losses for the jurisdiction in question. For example, losses may be greater in an event that results in the complete destruction of a high-rise building; in that scenario, losses will stem from loss of life, the actual destruction of the building, and business interruptions. For comparisons sake, the total losses incurred by New York City in the September 11, 2001 attacks are estimated at $83-95 billion. This loss estimate includes lost tax revenue for the city, the cost of response and recovery, business interruptions, deaths, building damage, and infrastructure damage. On a large scale, it destroys major portions of a large citys infrastructure creating physical and economic hardship for some time in addition to the initial death and destruction. Additionally, a terrorist event, especially cyber terrorism, can largely disrupt a communitys way of life by preventing individuals from locating and communicating with loved ones, and preventing accessing money held in banks. Property/Facilities/Infrastructure the type and magnitude of the terrorist attack will determine the damage or destruction to property, facilities, and infrastructure. Buildings can be destroyed or rendered unsafe, equipment, electronic or mechanical, ruined or in some cases made inaccessible due to damage or contamination. Explosions and fire can render infrastructure such as roads, power lines, natural gas, fuel, water pipelines, and sewage control facilities inoperable. Responders Impacts to responding personnel are similar to what can affect the citizens residing or working in the target area. They include medical problems and death from chemical agent exposure, explosion and fire trauma. There may long-term hazards such as hazardous chemicals or material (asbestos) that can cause illness, either acute or chronic. Continuity of operations for agencies that have their main administration or critical components of their operations within the target area could find their operational continuity at risk. If files, paper or electronic, are damaged or destroyed, an organization may not be able to: contact clients; assign work; complete scheduled jobs; meet deadlines; access, track, and pay accounts; or pay staff. Without a Continuity of Operations Plan that takes these issues into account, they may not be able to operate in their normal mode, if at all. Environment/Cultural the impacts to the environment from a terrorist attack can be significant if not devastating.

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