Healthcare
The fixed dollar amount a beneficiary has to pay.
What is a copay?
This plan has no out-of-network benefits.
What is HMO?
The Infinitus digital assistant.
Who is Eva?
The person that directs your care, or provides a referral to a specialist.
What is the primary care physician?
This is the identifier for a medication, product, or drug.
What is J code?
Another name for a Doctor, Lab Technician, Nurse Partitioner, etc., who gives a service or treatment.
What is a Provider?
The structure a patient visits to receive health services.
What is POS?
When activated, you will be routed to the next available call page automatically.
What is ready for call?
The prompt used when the plan is terminated.
"Does the patient have a different active plan on file?"
This is how insurance companies define the way a drug given.
What is the admin (administration) code?
The person or entity responsible for the payment of the insurance premium.
Who is the policyholder?
Healthcare coverage provided by the DOD.
TFL
A prompt used to clarify or confirm information from the agent.
What is a pushback?
Medicare, Medicaid, Tricare
What are types of Government Health Insurance Plans?
This is the pushback question we ask when we get a copay for the admin code.
Does the deductible apply?
This process is commonly known as fail first.
What is step therapy?
An automated phone system technology, that allows humans to interact with a computer-operated phone system through the use of voice and DTMF tones input via a keypad.
What is IVR?
Extra information that is sent to the client that isn't listed in the platform input.
What are external Task Notes?
The 3 pieces of information provided before gracefully ending a call when the patient can't be located.
What is Name, DOB, and Member ID?
Agents who provides the J code and the specialist office visit cost share together.
What are bundled benefits?
The other name for a "fee for service" plan.
What is an Indemnity Plan?
The total amount of time you have spent on both the active calls page, and on active calls today.
PST
This button is used before logging off for breaks, lunches, etc.
What is the available toggle?
This plan may begin in ANY month other than January and run 12 consecutive months.
What is a benefit year plan?
The pushback used when a copay is given for a medication.
What is "and coinsurance?"