Dual
A beneficiary with extra help would need to qualify for this, in order to change MA or PDP that Medicare auto enrolled them into.
What is a Special Election Period (SEP)?
This is a green letter sent out to bene's from Medicare.
What is a facilitated Enrollment Notice?
This is the option a bene has to ensure that they aren’t automatically enrolled in a MA/MA-PDP in the future.
What is Opt out of autoenrollment?
This applet on the MA-PDP view shows whether a bene has already opted out of autoenrollment.
What is the MA PDP Information form applet?
These are the fields CSR's can you use to give information regarding the status of an escalation.
What are the Case Status and Resolution Summary fields?
Information found here is considered general and can be shared with any caller.
What is the content viewer/scripting?
This is a kind of statement referring to when something is inaccurate such as:
"Mr. Jackson can enroll in both a Medicare Advantage plan and a Medigap policy."
What is a False statement?
This script will assist you with telling bene's what medicare covers when they go to the doctor’s office
What is Medicare Part B Coverage script?
This is the action you should take to before assisting an unauthorized caller with an MSN.
What is pass disclosure?
This is the timeframe for "any other complaint" rather than an urgent or immediate one.
How long is 30 days?
This is the mandatory piece of information the bene can provide to pass disclosure instead of their Medicare number.
What is a Social Security Number?
If a bene has no internet access and needs proof of coverage for a doctor's appointment tomorrow, according to scripting, you should do this.
What is refer them to their local Social Security Administration (SSA)?
This script can help you identify your next steps for an open MA PDP Complaint escalation.
What is the Plan Concerns and Complaints script?
After locating a denied claim, you can review this field to gain insight on why the claim was denied and relay the message to the caller/bene.
What is the MSN Message field?
This is other insurance that pays before Medicare at the time a claim is submitted.
What is a Medicare Secondary Payer (MSP)?
This is where you should record questions so that you can refer to them and the bene doesn’t have to repeat themselves.
What is the DASHBOARD?
A sort of supplemental insurance that could help reduce costs associated with Original Medicare copayments, coinsurance, and deductibles.
What is Medigap?
An extra amount that you pay for your Medicare premiums if you didn't enroll on time or experienced a lapse in your Medicare coverage.
What is a Late Enrollment Penalty (LEP)?
This is the piece of paper a caller needs if they are not authorized to be assisted by CSRs regarding a bene's claims.
What is a Medicare Summary Notice (MSN)?
This is how long a LEP lasts.
How long is Forever or as long as you have Medicare?
A date generates in this field on the BCC Tier 1 Screen under the Beneficiary form applet after a CSR request a replacement Medicare card be sent to a bene.
What is the Medicare Card Request Date field?
After you’ve used scripting and Next Generation Desktop to explain the status of a MA-PDP complaint, and a bene still has questions. According to scripting, you should do this.
What is refer them to contact the plan directly for more information?
You should use this script when speaking to a state health insurance assistance program (SHIP) counselor to determine what information you can release.
What is the Authorizations script?
You should look for this indicator when a bene hasn't received their Medicare Advantage card for a plan they were enrolled into more than 30 days ago.
What is the open escalation indicator?
This field on the MA-PDP View under the MA-PDP Information form applet will alert the CSR that the Bene has opted out of future Autoenrollments.
What is the Part D Auto Enroll Opt Out Flag field?