CLINICAL PROFILE
WHAT TYPE OF MEDICATIONS ARE FOR "MAH"
WHATS IS 'HYPERTENSION"
WHAT TAB DOES THE"ORGANIZATION DETERMINATION" NEED TO BE DOCUMENTED ON IN FACETS ?
WHAT IS THE "MEDICARE TAB"
WHAT SYSTEM WOULD YOU USE TO INITIATE A COVERAGE DETERMINATION REQUEST?
WHAT IS " PAS"
WHAT IS "PAS"
Medicaid pays their Medicare Part B premiums only, also pay for Part A premiums only depending on the MARX medicaid category?
WHAT IS "PARTIAL MEDICAID"
WHAT IS "SOCIAL DETERMINANTS"
IF A PRIOR AUTHORIZATION WAS DENIED, WHAT IS THE NEXT STEP?
WHAT IS AN "APPEAL"
HOW LONG DOES A MEMBER HAVE ON THE DUAL PLAN ONCE THEY LOST THEIR MEDICAID?
WHAT IS "6 MONTHS"
WHAT SYSTEM DO YOU ACCESS TO CONFIRM A MEMBER'S "MANAGED CARE ORGANIZATION"
WHAT IS "DMEVS"
WHAT SYSTEM WOULD YOU USE TO ACCESS MEDICAID ELIGIBILITY FOR THE STATE OF NY?
WHAT IS "EPACES"
WHO WOULD YOUR MEMBER NEED TO SPEAK WITH FOR "COMPREHENSIVE MEDICATION REVIEW"
WHAT IS "PHARMACIST"
WHAT IS THE STATE OF NY REQUIRED CALL CLOSING
WHAT IS " "Are you satisfied with the service I provided you?"
IF OUR SYSTEMS (GPS/ CPS FACETS) DOESN'T MATCH MEDICARE'S SYSTEMS (MARx), WHAT REQUEST WOULD WE HAVE TO DO?
WHAT IS "BREC"
IF NEEDING TO CHECK FOR "REAL TIME" CLAIMS FOR PRESCRIPTIONS, WHAT SYSTEM WOULD YOU USE?
WHAT IS" RxClaims"
WHAT IS "LIS LEVEL 1"
WHAT DOES "CBP" STAND FOR
WHAT IS THE PROPER TERM FOR FILING A FORMAL COMPLAINT
WHAT IS A "GRIEVANCE"
WHAT FORM DO YOU ASSIST THE MEMBER WITH, IF THEY ARE NEEDED MEDICAL SERVICES FOR BENEFITS NOT COVERED UNDER THE PLAN?
WHAT IS THE "MIOD FORM"
WHEN NEEDING TO FIND OUT A MEMBER'S "CASE WORKER" WHAT SYSTEMS DO YOU NEED TO ACCESS?
WHAT IS "COMMUNITY CARE"
WHAT LEVEL OF LIS DOES THE MEMBER HAVE A $89 DEDUCTIBLE?
WHAT IS "LIS LEVEL 4"
WHAT TYPE OF MEDICATIONS DOES "MAD" STAND FOR?
WHAT IS "DIABETES"
WHAT IS ..Deductible (D)
Initial coverage (I)
Coverage gap (G)
Catastrophic (C)
THESE APPOINTMENTS INCLUDE:
IMPORTANT HEALTH SCREENINGS
REVIEW OF CURRENT MEDICATIONS
DIETARY CONCERNS
FOR MEMBERS TO DISCUSS ANY HEALTH- RELATED CONCERNS
WHAT IS " HOUSECALLS"
WHAT SYSTEM DO YOU ACCESS FOR THE "RISK STRATIFICATION ASSESSMENT"
WHAT IS " ICUE"
Medicaid pays their Medicare Part A premiums, if any, Medicare Part B premiums and, to the extent consistent with the Medicaid State plan, Medicare deductibles and coinsurance, and provides full Medicaid benefits.
WHAT IS "QMB PLUS"