General Knowledge
This abbreviated agency oversees all things in federally facilitated and stated based health insurance.
What is CMS?
Call records, claims information, and outreach attempts
What is the minimum information needed for a Dallas escalation?
This is the abbreviation for the newest CMS category of UPS.
What is Unauthorized Plan Switch?
This CEO took over Centene in 2022
Who is Sarah London?
The unabbreviated platform in which CMS processes cases.
What is Health Insurance Casework System?
This abbreviated document is used to reconcile member accounts.
What is the ER&R form?
Narrative states member name is incorrect and the policy is still active.
What is a Demographic Dallas escalation?
Two of these are required for UPS cases according to CMS guidelines
What are verbal outreach attempts?
Better health outcomes at lower costs
What is the Centene Mission statement?
The abbreviated platform that is the HICS source of truth.
What is SEED?
Oh No! This 9/1/23 span is in SEED, but not in Softheon. Perform this to make sure the account is accurate.
What is a Carve-Out?
606 Error, UMV Span missing, Agent Validation-Start Date is after End Date
What are Embark exceptions?
The source of all our problems, specifically UPS cases.
What are crooked brokers?
Where your personalized learning and development journey begins
What is Centene University?
The internal casework system an MML uses to resolve HICS cases.
What is PRIME?
This might be "triggering" but needed to update a member's account without adding to ER&R.
What is an IC834?
A state regulatory agency that members can make a complaint to regarding fraud, compliance, and conduct.
What is the DOI or Department of Insurance?
CMS guidance for the subcategory of SEP but the narrative and member state Unauthorized Plan Switch
What is a UPS Dallas Escalation?
What is Archer?
Intentionally or unintentionally, these items are routed and have a goal of 25 per day.
What is an OMNI Intent?
This abbreviated nuisance cancelled my reinstatement.
What is a DMR?
Member had a baby 9/18, but member wants coverage 10/1/2023
What is a NB SEP in which coverage takes effect 9/18,11/1, or 12/1 and does not go to Dallas?
Ambetter, BCBS, Ambetter, BCBS, Ambetter
What is a Direct Dispute?
525,600 minutes to measure a year or 25,000 of these to get discounted insurance.
This application closes unexpectedly, using it or not, all the time, almost never.
What is ATMOS, UMV, Softheon?