What SOP
Mobile App
Self Service Advocacy
Only allow 25 visits
Hard limit
COB
Cordination of benefits
Rule 1
Non-dependent/Dependent
What is sensitive information
Birthday, diagnosis, ss#, mental health
Providing confidential information
HIPPA advocacy
unlimited visits
Soft Limit
ORS
Rule 2
Dependent Child/Parents Not Separated or Divorced/The Birthday
What is General information
Eligibility information, provider information
Advocacy dashboard
Proactive Member Advocacy
Fixed Dollar amount
Copyment
IEX
Work Schedule
Rule 4
Active/Inactive Employee (Laid Off/Retiree)
parent calling on dependant over 18 years of age
Need to verify, name, date of birth, and speak on behalf
Benefit information for medication
Pharmacy Advocacy
a % of shared cost between you and your health plan
coinsurance
SPE
Special Process Expert
Rule5
COBRA Continuation of Coverage
What information is confirm only
Where would I look if a Member is calling to provide consent for thier ONN provider.
Behavioral Health A4Me Call Handling & Benifts coverag Adcovacy. Would end up Transfering the member to UBH
$ amount for service before health insurance pays
Deductible
CPT
Billing Code from provider office
Rule 6 & 7
6-Longer/Shorter Length of Coverage
7-Shared Expensis
Third Party