Address Change
This screen shows demographics.
What is PEDM?
This is the AEP for Medicare members.
What is Oct 15th through Dec 7?
This means the claim paid through.
What is PWE or PAC?
This payment is completed over the phone and posted the same day.
What is a one time/same day payment?
What states are not fully cost share protected?
This screen creates a task.
What is PATR?
This is added for not having drug coverage.
What is LEP?
This means the claim was denied.
What is DNI?
This payment method takes 90-120 days to process.
What is SSA deductions?
What screen in CI provides information on a member's Medicaid eligibility level.
What is MEVH?
These policies allow the member to be OSA for 12 months.
What are PPO and PDP
*Daily Double* This program is available for those needing assistance paying for their Part D premium, deductible, coinsurance and co-payments.
What is LIS?
This means the claim denied do to a RTS.
What is error code 080?
This system is used to make a payment.
What is eBilling?
*Daily Double* The four basic eligibility criteria.
What are eligible for Medicare Part A and B, not have ESRD, live in service area and not have ESRD?
*Daily Double* Member must be advised of these things when moving permanently.
What is contact SSA and speak to mail order?
This is a state sponsored program designed to assist low income individuals with their prescription drug benefits.
This means that the claim denied due to having other insurance.
What is a 090 error code?
*Daily Double* This is the time frame for a payment to post to a member account.
What is 2-5 business days?
The two options for Florida on the DBCC tool.
What are the Fl Hum Full and Fl Hum Subset?
This system is used to verify name changes made through CMS.
What is Litton?
Member is requesting coverage for a non-formulary drug.
What is a formulary exception?
This override is handled by the pharmacist.
What is a vacation override?
This screen in CI is used to determine the member gaps of drug coverage.
What is PCCV?
This policy potential has Medicaid coverage however, does not require the member is enrolled in Medicaid.
What is the Humana Value Plus Plan?