Take Over
Blank space
internal or network change
What does it mean if the policy shows ESC in the coverage field?
Employee, Spouse, Child
What is Policy
A contract between an individual or group and an insurance company that provides financial protection against medical expenses
Red Flag
Rescission- ineligible for coverage
******
break in coverage
EC?
How many dependents are covered
3x4 segments
W7 under department code
7 day waiting period
True or False? Accumulators & limits start over; pre-existing DOES NOT start over when X is in the take over field
False
Coinsurance
the amount the policyholder is responsible to pay, which is a higher amount than a copay.
06-12-2023
Internal change in policy
How to determine which dependent is Terminated
Check the status under dependent information in coverage history T=Terminated