Giving You the Benefit
A free program available to all KP members, giving them access to a variety of health, wellness, and fitness tools
What is Choose Healthy?
Offerings vary by region, but this optional benefit may include enhanced benefits for dental, hearing aids, eyewear, and fitness.
What is Advantage Plus?
This system allows you to check to ensure that a newborn doesn’t already have an MRN.
What is Foundations?
These particular CSRs are expected to handle MFA related calls.
What is Tier 2 & 3?
A policy enabling members to receive care in the event that there is a delay moving membership data into our membership system.
What is the "Believe Me Policy"?
The action taken if a Medicare member is disputing their termination during business hours.
What is initiate a 3-way call to Medicare Membership Administration (MMA)?
The legal authorization for a designated person to make decisions about another person's property, finances, or medical care.
What is a Power of Attorney (POA)?
This is always expected at the time services are rendered.
What is Cost Share?
A way that you can recognize your peers and leadership for living out the HPPSA Service Values.
What is People Matter, I Matter nomination?
SURGDAY
What is the benefit code for Surgery - Outpatient Procedures?
Something we should never do when changing a Medicare member's address.
What is back date?
The primary resource for providing cost estimates.
What is the National Cost Estimate Tool?
Oakland, CA
What is the state where KP was founded/headquartered?
The process of sending a patient to another practitioner for consultation or a health care service that the referring practitioner believes is necessary, but is not prepared or qualified to provide.
What is an Outside/Out of Plan Referral?
Medicare Advantage members are entitled to this for new enrollees who are undergoing an active course of treatment in Part C medical benefits.
What is a 90-day transitional coverage period?
This KP department is responsible for validating restraining orders and custody orders to determine whether additional protective measures are needed.
What is Privacy, Security, and Technology Compliance (PSTC)?
These should not be sent without the charges and adjustments being completed and final.
What is an Itemized Bill?
A tab on kp.org where information about in-person, over-the-phone, and online wellness programs can be found
What is Health & Wellness?
Something that member's experience outside of open enrollment, where they can change plans or apply for health care coverage.
What is a Qualifying Life Event?
The amount of time KP's MMA department takes to process enrollment requests.
What is seven days?
Something that can be taken from any member in any region without the need to transfer.
What is a Complaint?
The department that handles service billing escalations (i.e. the caller stated/threatened to go to the media, an attorney, or KP executives)
What is Patient Financial Services (PFS)?
Groups at KP that foster a culture of belonging,
growth, and empowerment in the workplace.
What are Business Resource Groups (BRGs)?