Terms
Systems
Products
HIPAA
Values
100
What is the management service provided by a third party for an employer group that is financially at risk for the cost of health care services.
ASO
100
What is the system that you use to view information and record all calls?
ISET
100
This product offers both INN and OON benefits and does not require a PCP selection
Choice Plus
100
What is the legeslation that is designed to guarantee patients rights and protection against the misuse or disclosure of their health records?
HIPAA
100
Walk in the shoes of those we serve and with whom we work
Compassion
200
What refers to money that an individual is required to pay for services, after a deductible has been satisfied?
Coinsurance
200
What is the system used to verify benefits?
iBAAG
200
This product allows members to choose any provider and does not require notifications
Indemnity
200
What is individually identifiable health information relating to health care provided to an individual?
PHI
200
Invent the future, Learn from the past
Innovation
300
What is the reimbursement account that is funded by the employer?
HRA
300
What is the system used to locate Spending Account information?
CAMS
300
This product offers only INN benefits and requires a PCP selection
Select
300
You have to verify the name and obtain the phone number for this type of caller?
Other
300
Build trust through collaboration
Relationships
400
What is the average rate used for Out of Network claims
Reasonable and Customary
400
What is the system used to update COB when ISET is not working?
CDB
400
This large network houses the Choice, Choice Plus, Select, and Select Plus products
Managed Care
400
You have to obtain the name, date of birth, and verbal permission for this type of call
Caller for anyone over 18
400
Demonstrate Excellence in everything we do
Performance
500
What is the vendor network that is used when it is too costly or not prohibited to set up a provider network in the area?
Shared Savings
500
What is the system used to house all reference material?
MyCoach
500
This describes High Deductible Health Plans and what type of financial arangement they have
I-Plan
500
What is the type of information that can not be given out unless the subject is physically on the phone giving permission for disclosure?
Sensitive
500
Honor commitments. Never compromise ethics
Integrity
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