Workflow
What system acts as the middle man between the Marketplace and Florida Blue?
Edifecs
QTY*TO*4
QTY*DT*3
QTY*ET*1
How many Dependents?
3
PSP stands for?
Post Sales Processor
Billing Address
This system processes paper payments?
MellonBank
This system completes the fulfillment functions triggered from MembersEdge earlier in the process, sending the Welcome Kit, benefit summary, and ID cards to the member.
O'Neil
What Tab in PSP is the 834 file located under?
Transaction Info
This PSP Main Menu option allows us to manually enter a new enrollment application?
Paper Application Entry
What Screen and Tab can we update members Gender Status?
Member Maintenance/General Tab
Members can find a PDF version on their bill in this system if they opted to receive either paper or electronic invoices?
Member Website
Which system is used for both On and Off Marketplace plans?
Siebel
What tab in Edifecs is the 834 file located under?
Data View
This PSP Record Status shows when product is not available in the members county of residence?
Business Denied
If member wants to update the Month/Year of their DOB they have to submit documentation. What documentation can we accept?
Birth Certificate
Current Drivers License
State ID card
In Edifecs if an 834 file shows a Begin Date and End Date on the same line this means?
Non-Payment File sent to the Marketplace from NASCO.
PSP completed what 3 task during the enrollment process?
Address validation, Product mapping, Assigning contract ID
What is the Segment Tag that indicates the start of a transaction set?
ST
This PSP Main Menu option allows us to search for an view a transaction, cancel and enrollment application and resolve an exception?
PSP Entry Tool
What screen can you update the members Subsidy?
Member Subsidy Maintenance
What two screens are primarily used in Waypoint?
Trackers and Payments
A member would have to actively renew there policy ,for On-Marketplace plans, only if they had to? (2 Answers)
1. Change Health Plan
2. Update their Subsidy Info
What Segment Tag and Element Identifier (01 position) proceed the members HIOS ID in the 834 file?
REF*CE
This PSP Main Menu Option allows us to change a plan or member information (i.e. add/terminate dependent)?
Contract Changes
What sections of the Access Authorization Form have to be filled out for processing?
Section I, III, V, VIII
What dishonored code indicates insufficient funds?