Anthem
Terminology
Medicaids
MyCare
Pop Quiz
100
This goes in front of the numbers on the Anthem Insurance Card.
What is the Alpha-prefix.
100
A Rule in the insurance industry which states that the parent whose birthday is first in the calendar year is the primary subscriber for the dependent child.
What is the Birthday rule.
100
What HMO Medicaid cards use the MMIS number for their ID numbers?
What is Buckeye and Molina.
100

Name the 4 MyCare plans

What is Buckeye, Caresource, United Healthcare and Aetna

100

Where can a copy of the Soarian Insurance Master and Summa Contract Management list be located?

What is Summa@work *Bonus for 200 points - Demonstrate pathway*

200

We are contracted with Anthem MediBlue Prime Select.

What is No.

200
A specific charge that the health insurance plan may require to be paid for a specific medical service or supply.
What is a Co-pay.
200
What Medicaid marketplace insurance do we not accept at Summa Health?
What is CareSource Marketplace.
200
What does the Optum Rx logo identify on a MyCare card
What is Patient has Medicare benefits through another payer
200
If the insurance plan is within the Soarian Insurance master does this indicate Summa is contracted with the plan?
What is No
300
Anthem Senior Advantage is what type of insurance card?
What is a Medicare Card.
300
A state administered program funded partly by the federal government that provides health care services for certain low-income persons and certain aged, blind, or disabled individuals.
What is Medicaid.
300

When there are multiple insurances what priority should Medicaid be billed?

What is payer of last resort

300

What does the Medicare Rx logo on a UHC Mycare card identify?

What is Patient has Dual MyCare coverage

300
What is the difference between UHC AARP and UHC AARP Medicare?
What is UHC AARP is a supplement to Medicare - UHC AARP Medicare is a Medicare HMO replacement plan
400
If there is no alpha prefix on the front of the insurance card, then you need to look where?
What is the back of the insurance card.
400
This plan offers members services for a fixed fee. Members receive financial incentives to use a plan affiliated doctor or hospital, generally paying no deductible and a very small co-pay. Services rendered by an out of network physician are typically covered at a lower % than services rendered by a network physician.
What is PPO-Preferred Provider Organization.
400
When is it appropriate to allocate the Medicaid SLMB product?
What is never
400
If patient dual MyCare coverage how many insurance plans would be allocated?
What is 2
400
What indicates on the patients UHC insurance card that it is a UMR product?
What is The UMR logo and the 5 digit electronic payer ID
500
Where do we bill all of our Anthem and BC/BS claims?
What is the Local Anthem Insurance company.
500
Any insurance policy or health services contract by which groups of employees and often their dependents, are covered under a single policy or contract, issued by their employer or other group entity.
What is a Group Insurance.
500
For Caresource should the MMIS or the Caresource Member ID number be used as the policy number?
What is Caresource Member ID number
500
Is it possible to have MyCare Medicaid with another Medicare or Medicare HMO product primary
What is Yes
500

This is used as the ID number for VA

What is the SSN

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