Medicare Basics
Medicare is the federal health insurance program primarily for people age ___ and older.
What is 65?
Independent Health uses these specially trained community representatives to help members understand their coverage
Who are the Redshirts?
A call expressing dissatisfaction about any aspect of care, service, or customer service
What is a grievance?
What does HIPAA stand for?
What is the Health Insurance Portability and Accountability Act?
These services, such as EAVs, may be covered with a $0 copay
What are Preventive Services?
This part of Medicare helps cover hospital stays
What is Medicare Part A?
Independent Health Medicare Advantage plans often include these three popular extra benefits that are not a part of Original Medicare.
What are dental, vision, and hearing benefits?
This skill helps representatives understand the member's concerns and build trust.
What is empathy?
This is where you can look to find out if a HIPAA form is needed in a situation.
What is the HIPAA Grid?
Independent Health offers hearing aid benefits through this hearing partner.
What is Start Hearing?
This part of Medicare helps cover doctor visits and outpatient services.
What is Medicare Part B?
This national fitness program is included with many Independent Health Medicare Advantage plans.
What is Silver Sneakers?
This is where you send grievances when you are done documenting them.
What is MCRGRIEV?
This type of information includes a member's name, date of birth, Medicare ID number, or medical information.
What is Protected Health Information?
These are the things you do in a call with a member to remind them of their preventive services
What are MAP engagements?
This period of time occurs each fall and runs from October 15 through December 7
What is AEP or Annual Enrollment Period?
Members can talk to a doctor anytime by phone or app through this service.
What is Teladoc?
This is how long members have to file a grievance.
What is 60 days?
Before discussing a member's health information, you must first do this.
What is verify the member?
This emergency device benefit helps members feel safer at home.
What is PERS or Personal Emergency Response System?
Medicare Advantage plans combine Medicare Part A and Part B and often include this additional coverage.
What is Medicare Part D? or What is Prescription Coverage?
This means a member will not have any copays or coinsurance to pay and they must present both of their cards to their providers.
What is QMB
These are the things Sister Sue or Cousin Burt need to file a grievance for the member
What is HIPAA & AOR or verbal auth or HCP w/LOI
These are the things on the HIPAA you need to check to discuss things like mental health and urology claims.
What are the Special Conditions?
This preventive service is more in depth than a regular annual exam.
What is the EAV or Enhanced Annual Visit?