CAPS stands for...
What is Core Administration Processing Solution
This is the system Contact Center associates use to support plan sponsors, producers, providers and members.
What is Service Desktop
This CAPS system will be used for producer licensing, appointments and commissions.
What is PMACS?
In Plan Ready, this view allows you to pick one sponsor and see everything about them on a single screen, along with every transaction tied to that plan sponsor.
What is Plan Sponsor holistic view?
These plans are available to submit a claim on the member portal and mobile app.
What are Dental and Vision Perfect plans?
Nebraska became a state on March 1st of this year.
What is 1867?
This is the dashboard used when a call comes in from a member's dentist office.
What is the Provider dashboard?
This is what checks the provider's license against the outside source that issued the license.
What is Primary Source Verification (PSV)?
This is the most powerful piece in the game of chess.
What is the Queen?
This is the Plan Ready role that can edit the Benefit Catalog but only view the rest.
What is Benefit Configuration Analyst?
This is the maximum number of diagnosis codes an examiner can enter when manually creating a professional claim.
What is 12?
CARS is replacing this legacy system as the tool for sales, quoting, intake and removal.
What is Sales Express?
An associate should always do this first before making changes for a caller.
What is confirm they're speaking with an authorized individual?
The system will respond in this way when a license comes back as revoked or suspended.
What is terminate the provider immediately?
The 3 top menus in PMACs include Profile Details, Commission Admin and......
What is Regulatory Compliance?
These are the 3 locked fields that cannot be edited by an implementation manager on a "revision with plan change" transaction in Plan Ready.
What is the Subscriber name, Plan Sponsor name and address?
This system handles the policy, billing, claims processing and enrollment.
What is Helix?
When the normal Roman calendar was expanded from 10 to 12 months, these were the 2 that were added.
What are January and February?
This is where to look at prior contact history to see what has been previously discussed.
Where is case history for that caller?
These are the 2 ways the provider changes reach the provider record.
This is the page that holds Profile Indicators such as Suspend Processing, Exclude from Statement, and Primary Profile.
What is Basic?
When the file finished intake, but not paid.
What is complete?
Vision, Hearing and LASIK claims are manually created using this feature in Helix.
What is Create a Professional Claim?
This is where every sales opportunity, along with created date, sales rep, producer, effective and due dates and status is tracked.
What is Opportunity Central?
This is the most used search method on the Provider dashboard when looking for the caller.
What is Provider lookup?
By tax ID, NPI, provider name, or other identifiers
This system generated form must be reviewed when a new network or specialty is added to a provider.
What is a fee schedule tied to that network?
This branch of the armed forces was founded in 1790 and actually operates as part of the Department of Transportation.
What is the U.S. Coast Guard?
This is the core rule that anchors the whole platform in Bill & Collect.
What is setup sections are read-only and flow in from Plan Sponsor and Member? The settings page is the only place a biller actually changes things.
What is Intake and Claims?
This Founding Father of the United States campaigned to make the Turkey the national symbol of the newly formed country.
Who is Benjamin Franklin?
This is the leading cause of death for beavers in the wild.
What are falling trees?