Insurance terms
Essential Health Benefits
A list of benefits that all individual and small group plans must provide under the health care law. this includes basic services, such as doctor visits and hospital stays.
What is the name of the main page on Dash?
Member Management
What does HMO mean?
Health Maintenance Organization
Where can you find your New Hire Curriculum?
Independence University (My IU)
which are the 2 main rules of training?
Attendance and Camara ON
GCNJ
Get Cover New Jersey (Marketplace)
What is the name of the app we need to have open to receive calls on Dash?
Genesys
EPO > Exclusive Provider Organization
What is the name of the page where you can find the JobAids?
Operations Reference Library (ORL)
Cup of coffee
Precertification
It means you may need extra approval from your health plan before you receive certain tests, procedures or medications.
What is the difference between ORL inside of Dash and ORL on IWAY?
The documents we would find on the ORL inside of dash are related to member specific plan and the documents on ORL thru IWAY are for every member or LOB
Which plan offers OON coverage?
PPO and POS
Where can you find the HIPPA Tool?
Operations Resource Center (ORC)
Medicare and Medicaid.
Qualifying Life Event
A change of circumstances that may allow you to enroll in coverage outside the annual open enrollment period.
Are we able to check billing information thru Dash?
No, we need to use other apps
Which plan has OON coverage and does not require a PCP
PPO
Do you have access to the Code of Conduct thru Iway?
Yes
What does AHNJ mean?
Amerihealth New Jersey
HDHP
High-Deductible High Plan
What is the name of the tab where we can check previous member interactions?
Member Journey
What is the difference between HMO and EPO plan?
EPO does not need PCP or referrals
Name the 4 different types of documents we can find on the ORL:
Job Aid (Blue)
Alerts (Red)
Desk Procedure (Green)
Member Documents (Yellow)
What is the other name for Affordable Care Act?
ObamaCare