Enrollment
When is Open Enrollment Period (OEP)?
January 1st and ends on March 31st
At what age is a member eligible for Medicare?
65 years old
What is the alternative ID used when the MemberID starting with 101 is not available?
Medicare ID/ REd, Blue, White Card
Solving the problem by answering the asked and unasked questions according to QUEST is?
Quality
Used to impersonate member's secure online account.
My Assistant
Which enrollment period has a 7 month enrollment period once the member becomes eligible for Medicare?
Initial Enrollment Period
What are the requirements for Medicare if the person is under 65 years old?
Disabled and is receiving disability benefits from Social Security or certain disability benefits from the RRB for 24 months
ESRD
What is used to validate a member when the DOB is incorrect?
Address
Ask probing questions to get more detail of the issue and its impact to the member according to QUEST is?
Understanding
Gives info about the provider and used to get provider's participation
Smart Front End
How many days before Medicare beneficiaries may incur a Late Enrollment Penalty (LEP)?
63 days or more
What does RRB stand for?
Railroad Retirement Board
What would be the specific service request for a member who askes about their monthly premium?
Premium and Payment
Questions beginning with "To make sure I’ve understood (heard)............" is an example of?
Paraphrasing
Create letters such as Disenrollment Form.
OBC
Yvette is new to Medicare. Her month of eligibility is in June. Her Initial Enrollment Period begins on March 1st and ends on September 30th. She submits an application on April 24th. When is Yvette's effective date?
Yvette's plan effective date is June 1st
Which part of Medicare, Part A, B, C or D, is referred to as "Premium Free" if Medicare taxes were paid while working for a defined amount of time?
Part A
In what year did Coventry Plans end?
2019
"Aside from checking your monthly premium payment, is there anything else that I can help you with?", is an example of a?
Summary
View letters and documents (such as reimbursement) sent to us by members and providers.
ECHS
Sylvia is 68 years old and will be retiring in January. Her insurance benefits end on January 31st, which enrollment period is she qualified for?
Sylvia qualifies for a Special Enrollment Period.
Name the part(s) of Medicare that are administered by a private insurance companies?
Parts C and D
An Allina Aetna member wishes to know where the chiropractic closest to him is located, which website would be used to better assist this member?
GPS - provides a more specific location
Informing a caller about the websites available at their disposal is a form of?
Advocacy
Access member information such as benefit details and mailed letters as well as compare plans and year-over-year plan comparison.
MAP Tools