ISET
The source code do you choose when searching for a member
CS
The benefit you would quote if the member is going to a podiatrist
Physician Office visit
Claims are considered an auto-recall fail
When it has been more than 7 days from the COB update.
The amount of eligible expenses the member must pay for covered health services per year before UnitedHealthcare begins paying for benefits.
Deductible
Where you would locate the process if a member is being billed more than what is listed on the claim
Claims advocacy
The Originator type when someone is calling who is not on the plan
other
The benefit you would quote if a member is having a laparoscopy
Scopic procedures-outpatient Diagnostics and Therapeutic
A vendor who provides for UnitedHealthcare consumer protections against surprise billing for claims processed
Naviguard
Health care facility that is not a hospital, and provides one or more of the following services on an outpatient basis as permitted by law:
Alternate Facility
Where you can locate FAQ about hearing aids
benefits and coverage
The section you can update a member's phone number
What is communication preferences
The UHC approved Shingles vaccine
Shingrix
Remark code when a claim meets the OOP
S6
Therapeutic application of manipulative treatment with or without ancillary physiologic treatment and/or rehabilitative methods rendered to restore/improve motion, reduce pain, and improve function in the management of an identifiable neuromusculoskeletal condition
Chiropractic treatment
Where you can locate the compassion card process
Building Trust through advocacy
The tab/subtab that we can search for a check in
claims-payments
The benefit would you quote if a member needed Oxygen
DME
The document that explains how the claim processed
Explanation of benefits/EOB
Used when a specialty exists, but the specialist cannot accommodate the patient's diagnosis
Gap exception
The system(s) that we use to search for benefits in ISET
Ava/Ibagg
A legal document that describes benefits, exclusions, Eligibility, and other terms of coverage for an insured plan
certificate of coverage-COC
A review of claims where procedures are cosmetic, investigational, experimental, or unproven
Medical claim Review-MCR
Services that are any of the following:
Custodial Care
Where you can locate dashboard processes
Proactive Member Advocacy