NCOMPASS
This Intent will generate if you need to email an EOB to a member.
What is Respond to Customer?
This rule applies to dependent children whose parent are NOT separated or divorced and both policies accept this rule
What is the Birthday Rule?
These out of pocket cost are included in the MOOP
What is the Deductible, Copay and Coinsurance?
This Direct command is used to find the Subscriber Number (SSN) using the Members ID (3hzn)
What is PE?
This system is used within Ncompass to answer, transfer and make phone calls.
What is the CTI toolbar?
This Task will allow you to find the members accumulation towards deductibles and MOOP
This type of insurance is provided for medical expenses related to an injury caused by auto mobile
What is No Fault?
Two separate MOOP limits for medical and prescription drugs
What is Split MOOP?
The payee code is used to indicate payment was sent to the provider?
What is Payee code j?
This system tells you the place of service and type of service with the use of Procedure & TOS codes.
What is HURK
The task used to view a members Coordination of Benefits .
What is the Manage Other Coverage task?
This insurance is usually primary when members are 65+ and not actively working
What is Medicare?
The deductible typically runs between Jan 1- Dec 31 of each year. Any amounts paid in the fourth quarter is usually considered as this.
What is the 4th Qtr Carry Over?
This Direct command allows you to find Authorizations in NASCO with the Members ID #
What is the AF command?
This document displays all claims for a selected time period?
What is the SOP?
The task used to view a members Coordination of Benefits .
What is the Manage Other Coverage task?
This rule is rarely used, if one policy uses the birthday rule and the other doesn't, this this rule applies and the male parent is primary policy
What is gender rule?
This is a deductible in which each member must satisfy the individual deductible until a specified number of people meet their individual deductible
What is a non-aggregate family deductible?
The Direct Command to search for the Providers Network Status.
What is PV?
PF accepted also
This deductible is used when one or all family members contribute towards a family set deductible.
What is Family Aggregate Deductible?
This tab on the Member 360 screen in Ncompass gives you links to other systems
What is the Supplemental Tools tab?
Payment is based on Horizons allowed amount for this type of insurance in Non Duplication of Benefits
What is Commercial Other Insurance
The description for MOOP
What is Maximum Out of Pocket?
The name of the file used in thee HURK Application
What is the Procedure File Maintenance ?
This tool is used to find the description of POS, TOS, Diagnosis class and the claim type?
What is the Basic Value Reference?
also accepted: NASCO appendix of values