PAYMENTS
HOW CAN MEMBERS AND APPLICANTS PAY THEIR PREMIUMS?
-MAIL IN PAYMENT
-MONEYGRAM
-DEBIT CARD ON PHONE (IVR) OR ONLINE
-ACH (CHECK BY PHONE)
-SET UP REOCURRING (EFT, ACH)
AL
ASSIST LINE
IN WHICH STATE ARE NEWBORNS AUTOMATICALLY COVERED FOR THE FIRST 31 DAYS?
MONTANA
WHAT IS THE DATE RANGE FOR OPEN ENROLLMENT?
NOV1-DEC15
WHAT SYSTEM DO YOU FIND POLICY INFORMATION?
RPI
HOW LONG DOES AN APPLICANT HAVE TO MAKE THE INITIAL BINDER PAYMENT FOR A NEW POLICY?
ON EXCHANGE: UNTIL THEIR EFFECTIVE DATE OR 30 CALENDER DAYS AFTER THE APPLICATION DATE. (WHICHEVER IS LATER)
OFF EXCHANGE: 30-calendar days after the date of the missing requirements letter or the application will be withdrawn. IF ONLY MISSING BINDER PAYMENT, THE APPLICATION WILL BE SUBMITTED BUT WILL REMAIN IN PENDING STATUS UNTIL PAYMENT IS RECEIVED.
CHIP
CHILDRENS HEALTH INSURANCE PROGRAM
AN ON EXCHANGE MEMBER WANTS TO CHANGE HIS PHYSICAL ADDRESS. HOW DO WE PROCESS THIS REQUEST AND WHY?
REFER THE MEMBER BACK TO THE EXCHANGE. A CHANGE IN ZIP CODE MAY REQUIRE A CHANGE IN COVERAGE.
WHAT YEAR DID THE AFFORDABLE CARE ACT GO INTO EFFECT?
MARCH 23, 2010
WHAT SYSTEM DO YOU USE FOR BILLING
SLP
CAN A MEMBER MAKE A PAYMENT ON A TERMINATED POLICY? IF SO WHAT ARE THE PAYMENT OPTIONS?
YES (CA'S cannot take payments over the phone on a terminated policy.)
-MAIL IN CHECK
-MONEYGRAM (CASH)
-DEBIT/ACH VIA IVR LINE
-BAM (ACH PAYMENT)
LEAD
-LIVE OUR PURPOSE
-ENGAGE WITH PEOPLE
-ADAPT FOR THE FUTURE
-DRIVE RESULTS
SHOULD UPDATED INFORMATION BE REPEATED BACK TO THE MEMBER BEFORE ENDING THE CALL?
YES
PLANS THAT WERE STARTED BEFORE MARCH 23, 2010 ARE CALLED?
GRANDFATHERED PLANS
WHAT SYSTEM DO YOU USE TO FIND MEMBERS, TAKE NOTES, AND AUTHENTICATE?
DASHBOARD
HOW DO YOU DETERMINE WHETHER AN APTC APPLIES TO THE POLICY?
-In RPI, in the Policy Information accordion, look in the Expected Subsidy field.
OR
-In SLP, the APTC is located on the Policy Dashboard screen's APTC tab (in the Billing section).
AOR
AGENT OF RECORD
HOW DO WE RESPOND TO AN EMAIL ADDRESS OR PHONE NUMBER CHANGE REQUEST FOR AN ON EXCHANGE MEMBER?
WE AN CHANGE AN EMAIL ADDRESS, HOWEVER WE MUST ALSO REFER THE MEMBER BACK TO THE EXCHANGE TO UPDATE THEIR INFORMATION
WE CANNOT CHANGE PHONE NUMBERS, THEY MUST DO THIS THROUGH THE EXCHANGE.
WHAT YEAR WAS HCSC ESTABLISHED?
1929
IF NOT FOUND IN RPI,WHAT SYSTEM DO YOU USE TO LOOK UP LETTERS, DOCUMENTS, AND APPLICATIONS?
TRACE
WHAT IS THE DIFFERENCE BETWEEN AN ACH, EFT, AND PAC?
There is no difference. EFT, ACH, and PAC are three different names for the same process - automatically transferring money from a designated checking or saving account to pay the member's monthly premium.
MPUI
MEMBER PROFILE USER INTERFACE
WHEN CHANGING A PCP FOR A MEMBER LOCATED IN IL, WHAT PROVIDER INFORMATION IS NEEDED?
NONE: MEMBERS CANNOT BE ASSIGNED PCP'S IN IL. THEY CAN ONLY BE ASSIGNED MEDICAL GROUPS.
WHAT DATE WAS HIPAA ESTABLISHED?
APRIL 14, 2003
WHAT SYSTEM DO YOU USE IF YOU CANNOT FIND A MEMBER IN ANY OTHER SYSTEMS?
MPUI: LAUNCH FROM DASHBOARD UNDER MP LAUNCH. THIS IS WHERE YOU FIND GROUP POLICIES AND SYSTEM 80 POLICIES.