MISC
MIIM
MYSME
A&G
100
Which category and intent would you use to update a members account when they the member says they don't have secondary coverage?
What is Plan & Update Member COB.
100
How many categories does MYSME have?
What is 7.
100
Member stated she believes after getting treatment at the doctors office she is currently still having pain in her hip?
What is Quality Of Care.
200
Members with this plan may need assistance locating willing or deemed providers?
What is PFFS (Private Fee For Service).
200
Which category and intent would you use if a member is requesting they Part D EOB'S?
What is Pharmacy and Explanation of Benefits.
200
What should your Business Area should say?
What is Customer Service.
200
Member stated they can't afford the cost of the prescription Xarelto?
What is Coverage Determination or Tier Exception?
300
So if the member was calling to update the last name who will assist the member with this?
What is Social Security Administration.
300
How many tabs does MIIM have?
What is 7.
300
Which wizard would you use if you needed to assist member with Premium & Payment questions?
What is Premium and Payment Inquiries.
400
So if a member would like to receive additional assistance with their prescription drugs and premium?
What is LIS (Low Income Subsidy).
400
If you needed to link something to another case in MIIM?
What is Link Related Item.
400
If a member wanted to know about the dental or fitness rider which wizard would you use?
What is Rider - Add, Change or Remove.
500
What does SPAP stand for?
What is State Assistance Pharmaceutical Program.
500
Member was calling and wanted to know about reimbursement which category and intent will you use to assist the member?
What is Plan and Educate DMR.
500
So if you needed to help verify someone that is calling on behalf of the member which category & job aid would you use in MYSME?
What is Browse Topics and HIPAA.
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