Knowledge Central
Is a stair lift / stair elevator covered in the DME list?
Stair Lift / Stair Elevator: Not covered under Medicare Guidelines; not primarily medical in nature
What is the definition of HIPAA
What is Health Insurance Portability and Accountability Act. HIPAA was created in 1996, and addresses a number of issues, including the protection of confidential enrollee information
What Eligible Family Members can be eligible to become Authorized Reps
Aunt
Brother
Daughter
Daughter-in-Law
Father
Fiancé
Grandchild
Husband
Life Partner/Partner
Mother
Nephew
Niece
Sister Son
Son-in-Law
Uncle
Wife
What does Part A cover?
Hospitalization costs
Whats your vision of relaxation?
Mine is drinking coffee on a porch watching the Sun Rise
Which Walkers (special types) are not covered in the DME list?
With basket: Not covered under Medicare Guidelines.
Can you give me an example of basic plan information?
What Is
Where can I update members address?
Update member Address Intent
What does Part B cover?
What is Physician Services, lab and x-ray services, durable medical equipment and outpatient and other services
Tell me something Motivational.
Just because you fail at once doesn't mean you're going to fail at everything -Marilyn Monroe
Who is eligible for the PERS program?
You must be part of a UnitedHealthcare Medicare Advantage plan that includes the PERS benefit to be eligible for the program. The benefit only applies to the plan member and cannot be transferred to family members or friends.
Note: An organization determination cannot be submitted for the PERS program. If the member changes to a plan that does not cover the benefit, they would pay out of pocket for the service.
What CANNOT be discussed without the members consent?
What is Member Sensitive Information is information which directly indicates the member may have a sensitive health condition.
Note: General Benefits, Coverage of these items can be discussed.
What Row is Send Non Marketing Materials under?
Under the Member Row
What does Part D cover?
What is Prescriptions
What are you afraid of?
Eye Balls
When are Mental Health Virtual Visits available?
Mental Health Virtual Visits are unlike Medical Virtual Visits. Mental Health providers offer specific hours of availability and the appointment time and scheduling must be discussed with the provider ahead of time, similar to other behavioral health appointments.
Definition of Coordination of Benefits
Coordination of Benefits occurs when a member has coverage through more than one plan. Members with alternate coverage are able to bill each plan for their medications/services. The provider will bill the primary coverage first, followed by the secondary insurance. The amount of coverage will not exceed 100% of the cost of the medication/service.
How much is Copay for LIS 3 Brand name prescriptions?
$0
What does MBI mean?
What is MBI stands for Medicare Beneficiary Identifier
Where would you want to go for vacation?
Iceland
What is the HouseCalls Program?
health care practitioners make in-home clinical visits with members to evaluate their health conditions. The program is designed to educate and help our members be proactive about their health. This visit is meant to support the care the member receives from their primary care provider. It does not replace their regular PCP visits or the annual wellness exam. There is no additional cost for this program to our members.
Can you give me the definition of Protected Health Information (PHI)
What is
Any information, including demographic information collected from an individual, whether oral or written, maintained or transmitted in any other form or mediums, that is created or received by a Covered Entity.
Every quarter you review your Medicare Summary Notice (MSN) or Explanation of Benefit (EOB) to ensure the services you received are properly billed. Your latest summary reflects an X-ray is being charged but you do not recall having this done at your last doctor visit.
You may be a victim of this.
What is Medicare fraud!
Whats your favorite Candy?
Lindor Chocolate