Acronyms
This type of plan gives a wider variety of providers for members to see.
What is a POS plan?
(Point of Service)
At the end of the second month of enrollment, this will happen to a member if their chronic condition verification is not completed.
What is a disenrollment from a CSNP plan?
Any person can join an MAPD plan.
False
Only beneficiaries who have Medicare Part A, B and D.
This type of plan covers Medical Only benefits.
What is an MA?
(Medicare Advantage)
When an enrollment application is received this is the members effective date.
What is the first of the following month?
An enrollee wishes to enroll in a Dialysis plan who has diabetes. Because they have diabetes, they qualify.
False
I need a plan that gives me medical and pharmacy benefits.
What is an MAPD?
(Medicare Advantage Prescription Drug)
What is the Initial Notice? (Exhibit 32)
We use Healthsoft to obtain provider information for outreach.
False.
We should be using Quick Base to look up the provider we need to call to confirm the member's condition.
I will need to provide this information to be able to access a member's medical information.
What is PHI?
(Protected Health Information)
A plan has this time period to verify a chronic condition.
What is two months?
Healthsoft is Gold Kidney's telephone system.
False.
Genesys is the phone system.
I have a chronic condition and need to join a plan that caters to my condition.
What is a CSNP?
At the end of the second month, members will receive this if their chronic condition is not verified.
What is the Final Notice?
Exhibit 33
80% of CSNP members need to have a chronic condition verification.
100% of CSNP members need to have their chronic condition verified to remain on the plan.