This will ensure there are not any issues with continuance of Auto-Pay.
What is
an End Date of 12/31/2099
100
The payment needed before an pre-member has access to any of their medical benefits.
What is
Binder Payment
200
If US Script says they show member as eligible,
What is: advise member of this, If the pharmacy is still having an issue the pharmacy can call US Scripts and US Script can walk the pharmacist through processing
200
15th through 31st must be chosen. If 31st is chosen the withdraw will happen on the last day of the month.
What is
Withdraw Date
200
Once the premium binder payment is received a New ________ is sent.
What is
Member Welcome Packet
300
If US Script says that member is ineligible, how do you queue this.
What is HIM Enrollment,Mark as High Priority if urgent
300
One should never set-up an Auto-Pay from a Quick Pay. Doing this creates the possibility of the draft not linking to the member’s Ambetter Account. how should auto-pay be set up?
What is
Auto-Pay must always be set-up using an invoice
300
Joe pays $110/mo and would like to know his status for November,
May 11th- $110, Paid in full
June 30th- $110, Paid in full
July 29th- $75, Paid on account
August- 28th- $110, Paid on account
September 2nd- $110
What is
Delinquent
400
There are two ways to document in CRM, what are they?
What is
Category Benefit Inquiry, Subcategory Pharmacy
and
Category Eligibility, Subcategory Vendor Eligibility Issue
400
If a member owes money (even if it is just for the present month) first a payment must be taken, then subsequently an Auto-Pay can be created. This includes but is not limited to binder payments.
What is
Present outstanding balance must be paid before setting up Auto-Pay
400
These items are found where
Welcome Brochure – includes member’s plan benefit grid
ID Card (every member under policy receives an ID Card)
NCQA required tip sheet
Language tagline sheet
Member Privacy Statement
What is
New Member Welcome Packets
500
When a member inquires about a prescription drug that is not listed on the Preferred Drug List?
What is
Call US Script, Ask US Script about Prescription Drug, Report findings back to Member
500
An easy way to access a member’s Auto-Pay information is to pull the member’s account
What is
eCashiering>Accept Payment (as if taking a payment) and click Auto-Pay.