This process ensures required annual member letters are client‑approved and contain all mandatory elements before mailing.
What is the Annual Letter Monitoring process?
The primary purpose of this process is to ensure MyPrime.com aligns with CMS Marketing Guidelines and the Medicare Open Enrollment period.
What is the Medicare Readiness process?
This NCQA standard we monitor applies to both Medicare and Medicaid
What is MEM4/5?
This number represents how many SOPs COR currently has.
31
This is what SOP stands for.
Standard Operating Procedure
Prime uses this Salesforce‑based workflow and regulatory tracking tool to manage and document the Regulatory Change Management process.
What is Riskonnect?
This profile is used instead of CSI to populate key EOB information during testing because files are run through RxClaim.
What is the Master D profile?
This is what ABD stands for in ABD Notice
What is Adverse Benefit Determination
According to this SOP, this is how often Print Vendors working with PHI are required to pass an audit.
Quarterly – SOP COMPDLY 03: Print Vendor On-Site Audit in Background
This person or group is responsible for approving an SOP.
The SOP owner or management
Daily Transition letters must be mailed within this number of business days after a claim is adjudicated.
What is three business days?
Annual Medicare plan documents are displayed in this location on the MyPrime website.
What is the forms page of MyPrime.com?
This is what ANOC stands for
What is Annual Notice of Coverage?
This SOP addresses compliance with the Web Content Accessibility Guidelines (WCAG).
COMM 15
This color of a flag describes the statement ‘I’ve always done it this way’ when evaluating SOPs.
A red flag
This source is used to validate required annual letter elements such as phone numbers, plan names, and signatures during monitoring.
What is the Client Specific Information (CSI)?
These identifiers are required in most Prime print materials sent to Medicare and Medicaid members, with limited exceptions.
What are Material IDs (MIDs)?
This is what VPAT stands for
What is Voluntary Product Accessibility Template
This SOP references member-facing materials such as letters, brochures, fliers, and emails executed by the Member Communications team.
MMS 02 – Review of Active Communications
This section of the Rehabilitation Act requires federal agencies to ensure accessibility.
Section 508c
After production, the vendor stores Daily Transition Letters for this length of time.
What is eleven years?
These digital communication types are explicitly exempt from Material ID requirements.
What are text messages, secure MyPrime messages, and emails?
This DTP contains an internal comment instructing someone to “Ask Amanda for a definition.”
What is Annual Letter Monitoring (Prime_DTP_MSS_03)?
This SOP identifies when CMS annually releases updated models via memo(s) identifying changes to EOBs.
PRIME_FULFLMT_28: Explanation of Benefits Annual Process
All Medicare marketing and communication materials, including digital content must follow MCMG review. What does MCMG stand for?
Medicare Communications and Marketing Guidelines