C&G
We use this code if a member declined a grievance
what is GCA082?
This plan is a provider specific plan?
what is Premier plan?
What does PRD stand for?
What is Personal Representative Designation
If there is no PRD on file in MC400 and the member wants to know if we at least received it we would check here
what is Filenet?
what is the code to order bathroom items for the member?
what is BSD?
we use this code if a member is only inquiring about a grievance?
what is gca070
This plan has a 750 deductible
What is the HMO rx Deductible
How long is a verbal attestation for a PRD good for?
What is 7 days
If a member wants to know if a medication is covered we use this
what is the formulary?
We use this code if the member is questioning anything enrollment related?
what is ELD010?
This plan costs $40 a month
what is the hmo rx choice plan?
Name two things a PRD cannot do
What is update PCP, Update address, change SSA, LEP attestation
We go here to see a members status of their grievance?
What is MEdhok?
We use this code to indicate we helped the member search for a new pcp
what is PVA010?
How do we let the members know the outcome of their grievance or appeal?
what is we send them out correspondence?
This plan has a $50 otc benefit amount
what is the hmo no rx?
Name three things that are considered PHI
What is Names, Postal Addresses, Dates, Telephone numbers, fax numbers, Email addresses, Social Security Numbers, Medical record numbers, Account Numbers and Health plan beneficiary numbers.
If a member gets a denial for a medical service we check here to bring up the letter?
what is healthplanet?
We use this code if we get hung up on :(
What is OTA020
To appeal a SNF if it is prior to noon the day before the last covered day they want to appeal it with _______
This plan costs the memebrs $301 a month
what is the hmo rx enhanced plan?
What does HIPAA stand for?
What is Health Insurance Portability and Accountability Act
We go here to view members dental claims
what is DNTPRD?
We use this code to term someone's plan due to death
what is enb022?