ABCBS Leadership
ABCBS Phone number
What is five zero one- three seven eight- two thousand
Members and their family members, Agents and their representatives are considered this type of customer
What is External Customers?
Products no longer sold but continually managed.
What are Closed Products
Payment due at the time of service
What is a copay?
Licensed insurance Agent who helps the customer enroll in and manage a healthcare plan
What is Agent of Record?
Who is Curtis Barnett?
Membership financial, membership Enrollment are considered this type of customer
What is Internal Customers?
Agency that provides care to patients requiring skilled medical care in their home
What is Home Health Agency?
Payment made monthly for insurance coverage
What is a premium?
March 23, 2010
What is the date when the ACA was signed into law?
Required when a member goes inpatient out of state or at an Out of Network facility
What is prenotification?
Customer Service Representatives, Correspondence Teams make up this department
What is Customer Service?
What is Formal Benefit Inquiry?
Act of 1996 which is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.
What is Health Insurance Portability Accountability Act?
Statement that is sent to a member after a claim has been processed.
What is an Explanation of Benefits?
Senior Vice President for Internal Operations
Who is Judy Blevins?
This area process claims and makes any necessary adjustments
What is the Claims Administration?
The type of products currently marketed and sold by ABCBS
What is Limited Duration products?
Total amount of member responsibility over a calendar year that can be capped at a certain amount.
What is an Out of Pocket?
Name, ID, DOB, and Address
What are the 4 points of authentication for a member?
ABCBS Regular Business Manager
Who is Wanda Davis?
This team maintains eligibility and membership information
What is Membership Enrollment?
This program provides vision care for members over 65 when services are provided by a participating provider
What is the MediPak Vision Care Program
Summarize what was discussed on the call.
Ask, “Is there anything else I can help you with today?”
Offer the reference number and survey
Thank the caller.
What is the wrap up and close the call step of the call flow?
Guaranteed issue, which prohibits insurers from denying coverage to individuals due to pre-existing conditions.
Dependents are permitted to remain on their parents' insurance plan until their 26th birthday.
Annual or lifetime coverage caps on essential benefits were banned.
What are the provisions of the ACA?