Knowledge Central
I am the job aid used to verify a member when calling in to UHC.
What is the HIPAA-Index?
I am the website that finds helpful resources related to food, housing, utility help, etc...
What is Aunt Bertha or findhelp.org
I am the government help that lowers the price of RX. I come in levels.
LIS (Low Income Subsidy)
EOB
I am the system you always start with when receiving a call.
What is Maestro?
I am the job aid used to help set up access for MARx
What is MARx Users Guide - User Registration ?
I am the end all know all website of the government that verifies eligibility
What is MARx
I am the list of prescription drugs.
What is Formulary
ANOC
I am the company's intranet.
What is Sparq?
I am the job aid that helps you with fulfillment for members.
What is Initial Fulfillment Requests ?
I am the system that houses Medical Prior Authorizations. I am the system that you will use to also complete Health Risk assessments.
What is ICUE?
With B vs D excluded, the turnaround time for an expedited Coverage determination would be this timeframe
What is 24 hours?
EOC
What is Evidence of Coverage
I house your schedules
What is IEX?
I am a decision tree to assist in answering member's questions regarding their benefits.
What is Quoting Benefits?
I am the website you must go to for initiation of a Coverage Determination. I must be filled out along with Maestro.
What is PAS (Prior Auth System)?
I am the intent in Maestro that quotes the tiers of RX for members.
What is Review RX Benefits?
MIOD
What is Member Initiated Organization Determination?
This job aid should be pulled up every time any grievance, OD, CD or appeal is being filed.
What is Compliance One Source?
What decision tree do you use to assist you in changing a primary care physician?
What is PCP Changes DT
I am the important step of any Organization Determination. I must be filled out along with Maestro.
What is the InfoPath Sharepoint (MIOD form)?
Besides Maestro, I am the DOSS system that houses a member's RX claims.
What is RX Claims
MARx
Medicare Advantage Prescription Drug
I am the process when the member disagrees with a plan's decision or the amount the member owes.
What is Appeal