Benefits
Diabetic Supplies would be under this benefit?
DME
What do you have to do to close a case properly in GPS?
Case comment, select at least 1 SR, fill in subject of call, click Finish
what system do you send a disenrollment form to the member?
OBC
What is covered under Part A
Skilled Nursing Facility, Hospital, Home Health Care, Hospice
Largest land animal in the world?
Elephant
Emergency services are the same copay In and Out of Network
True
Where do you go to order a Id card for member
menu navigation-member tab-id card
Where can you find the DME supplier list?
Wiki Tool
What are the 4 Enrollment Periods
IEP, SEP, AEP, OEP
What slogan is Finger lickin good
KFC
If a member calls in and does not have a benefit such as transportation where would you warm transfer the member to?
Resources for Living
How do you pull up the EOC
click policy name, then health policy documents, then EOC view
What systems is used for appeals and grievances?
MedHok
What are the qualifiers of Medicare
65 or older, Disability, ESRD
What is the only state flag that is two-sided?
Oregon
what do we cover for the chiropractor benefit
Manual manipulation of the spine
How do you get to see preauthorization's on file for the member?
menu navigation-clinicals-medcompass
What is ECHS and IOP
Document viewer from items sent to us by members
What day is the premium payment due for members?
by the 10th of the Month
What can you catch, but not throw?
A cold
What diabetic supplies are covered under Part B?
Monitors, lancets, test strips
What is the most common NBA you discuss with the member on the call?
Healthy Home Visit
In medcompass where do you go first to pull up the authorizations
Utilization Management
What are the two most common types of Medicare Advantage Plans?
HMO and PPO
What is a group of lions called
a Pride