Benefits
Where in facets can you find medical benefits to quote?
The Benefit Summary
Can a person that is not eligible for Medicaid enroll in one of our DSNP plans?
No, because DSNP plans are only for members with both Medicaid and Medicare.
WHERE IN FACETS CAN WE LOCATE CLAIMS?
Medical tab
THE SYSTEM WE USE TO VIEW MEDICAID CLAIMS?
Facets and/or Meastro
I belong in the month of December, but not in any other month. I am not a holiday. What am I?
The letter "d"
What is the name of the benefit that members can use to order out of the catalog or in a store selected by UHC? Ex. Walgreens
OTC Benefit
What are the four ways a member can disenroll from our DSNP plans?
Assisted Online Disenrollment, Submit a written disenrollment request, Enroll into a different PDP, MA-PD or MA-only, or lastly Call 800-MEDICARE to receive information on alternate plans
A MEMBER WITH THIS MEDICAID LEVEL WOULD HAVE TO PAY ALL PART C COST SHARE
LIS Level 4
THE SYSTEM WE USE TO CHANGE A PCP?
Maestro and/or GPS
When Billy's asked how old he is, he replies, "In two years I will be twice as old as I was five years ago." How old is he?
12 years old
This is the transportation vender for FL DSNP members.
Logisticare/Modivcare
What is the difference between disenrollment and cancellation?
In order to disenroll a member has to have been enrolled in one of our plans, and has already started it. In order to cancel a members plan has to have not started.
WHAT ACCOUNT DO YOU LOOK AT FOR MEDICAID CLAIMS?
FL Medicaid wrap account
THE SYSTEM WE USE TO SEARCH A MEDICATION THAT IS REJECTED
Rx system
Without a bridle or a saddle, across a thing I ride a-straddle. And those I ride, by help of me, though almost blind, are made to see. What am I?
Eye glasses
What is the difference between QMB members and partial member?
QMB members don't pay copays, coinsurance, or deductibles. While partial members do.
WHEN THERE IS A DISCREPANCY IN THE MEMBERS ELIGIBILITY WHAT SYSTEM WOULD BE THE SOURCE OF TRUTH?
Marx
WE CALL THIS PERSON WHEN MEMBER IS BEING BALANCED BILLED INCORRECTLY?
The provider or billing department
THIS SYSTEM WE USE TO COMPLETE HRA’S
ICUE
I'm everywhere and a part of everyone. I am at the end of space and time and existence itself. What am I?
The letter "e"
Where can members research their own benefits?
UHC community plan website
WHO DO WE CALL WHEN A MEMBER WANTS TO CHANGE THEIR PLAN?
Telesales
THE AMOUNT OF DAYS A PROVIDER HAS TO PROCESS A CLAIM IS?
30-60 days depending on the claim
THE SYSTEM WE USE FOR A COMPASSION EMBRACE
Maestro
You're in a dark room with a candle, a wood stove, and a gas lamp. You only have one match, so what do you light first?
The match