Medicare Part C is made up of which Original Medicare Parts?
Parts A & B
100
Refer members to call SSA, State Medical Assistance offices, www.socialsecurity.gov, or MyAdvocate to apply for what?
Low Income Subsidy (LIS)
100
What is the name of the tab where you can see recently worked items in MIIM?
Recent Work
100
How much call silence is appropriate before you should consider placing the member on hold?
60 seconds
100
Manage LEP is located in which catagory?
Billing
200
Members pay the most for their Rx Drugs in this phase of Part D.
Deductible stage
200
Who would a member call to file a CTM case?
Medicare (CMS)
200
A member calls and in order to answer his question, you need to verify his employers name and start date. Which tab in MIIM 360 View would you use to find this info?
Employer Group
200
What should be verified for an inbound Internal call?
Caller's first and last name
Caller's internal department
Member's first and last name
Member's DOBor Member ID or Medicare ID or Complete Permanent Address
200
A member calls in stating that she never recieved her ANOC and ID Card. Where would check to see when they were sent?
GPS Contact History
300
Dental, Long Term Care, Presciption Drugs & Vision are additional benefits NOT covered by what Medicare Plans?
Medicare Supplement Plan
300
Melissa recieves a letter in the mail stating that her copay for a prescription she filled in December was charged correctly. She states that this amount is still incorrect and wants us to look at it again. What type of complaint would this be?
Appeal
300
Complaints, Appeals and Grievances intent is located in which category?
Member
300
True or False: Basic plan info, Member claims info, Member enrollment info, Member medical info, and Sensitive member info can be discussed after verification of an inbound member call?
True
300
When are members eligible to add a rider on thier account?
Any time
400
True of False: Orginal Medicare includes Parts C & D
False
400
What can you use to HIPPA verify a prospect?
DOB, First & Last Name
400
How do you close an intent you opened in error?
Select Different Action> Cancel this work
400
True or False: LIS Status, PCP Change, and Plan changes can be updated when a Provider calls in
False
Only LIS Status can given
400
A member calls in about finding a new PCP in her area. She threw away her ANOC but wants a lis she can see online. What are the two websites you can provide her so she can view available PCPsonline?