Maestro
What is the purpose of Maestro?
Maestro is the Main Tool for member benefits, claims and most of the questions they may have, we also use it to schedule commitments and document the interactions.
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
Call the UHC Telesales or Marketplace
What does IFP stand for?
Individual and Family Plan
What is the name of the company that you work for?
Ibex
What is an Intent?
Intent is equal to "Activity or Task" is what we click in Maestro to help our member with Benefits and Claims related questions.
True - Minimum Necessary
What is Premium?
The amount you pay every month to have health insurance.
What was the goal of the Affordable Care Act (ACA) signed into law in 2010?
The goal of the ACA was to help more Americans gain access to health insurance coverage
What is the maximum allowed time that you can missed in Training?
8 hours
What is the Intent we should use when assistance the Member with Fooding, Housing, or additional benefits not included in their plan?
Social Determinants of Health - Intent
What must be Authenticated when an Authorized Rep is the caller?
What is a Duductible?
The amount you must pay for covered services before your insurance starts sharing the cost.
What are Marketplace Plans called internally by the company?
Marketplace Plans are called Individual and Family Plans (IFP) internally
What is your Trainer Full Name?
Paublo Steven Morales Mejia
What is the Intent we should open when scheduling a commitment for our members?
Schedule Activity - Intent
How can we HIPAA Authenticate a member when they call In?
First and Last Name
Date of Birth
One of the following: Member ID or DOB
Password if present in the System
A member has already met their deductible. A procedure costs $5,000 and the plan has 35% coinsurance with no copay. What is the member's responsibility?
$1,750
Who is eligible for tax credits under an Individual and Family Plan (IFP)?
Members enrolled in an IFP who have an income between 100% and 400% of the federal poverty level are eligible for tax credits that help reduce their monthly premium.
What department in Ibex is in charge of Activities such as Birthdays, Parties, Prizes, Raffles, etc?
Engagement Department
What is the Intent we should open when escalating to a Supervisor?
Transfer Case - Intent
TRUE OR FALSE
Trustees can receive Premium Payment Invoices from other's member's account as long as they are able to HIPPA Authenticate the Account.
TRUE
A member has already met their deductible. An MRI costs $2,000 and the plan has 25% coinsurance with no copay. What is the member's responsibility?
Member pays 25% of $2,000 = $500
How are the tax credits for eligible Individual and Family Plan (IFP) members applied?
The government pays the tax credits directly to the insurance company, which helps reduce the member's monthly premium.
What corrective action can apply if the Trainer finds someone sleeping in class?
Written - CA