Foundations
Provide better health outcomes at lower costs:
What is Centene's mission statement?
Centene's commercial insurance product:
What is Ambetter?
Must be done when greeting a Member:
What is put a smile on my face?
The amount you pay for certain services (in total) before your insurance starts to pay:
What is a deductible?
MOOP:
What is maximum out of pocket?
A patient and/or insured
What is a Member?
Centene's corporate office is in:
What is St. Louis?
The _________ team works with the health plans to handle member enrollment issues.
What is Eligibility?
The Affordable Care Act will ______ the number of uninsured Americans.
What is decrease?
APTC:
What is Advanced Premium Tax Credit?
Adjudicate submitted claims from providers
What is Claims?
Those that need the most financial help, would obtain health insurance through:
What is Medicaid?
Off or in silent mode (not vibrate) and put away during class:
What is electronic device (cell phone)?
According to the Affordable Care Act, everyone must have insurance as of:
What is January 2014?
FPL:
What is Federal Poverty Level?
A plan that encourages Members to engage in health behaviors, has a credentialed provider network and coordinates between providers, members and state for best health outcomes at lower cost
What is Managed Care?
Centene's product line includes:
What is medicaid plans, specialty companies and commercial insurance plans (HIM)?
Appropriate behavior and communications at all times; respect your classmates and Instructor at all time.
What is Professionalism/Class ground Rules?
The total amount you will spend for healthcare, after which the insurance company pays for all your medical care until the year ends:
What is maximum out of pocket (MOOP)?
SBE:
What is State Based Exchange?
Back-up during busy times and when call centers are unable to operate due to weather, possible disaster, etc...
What is the importance of Service Centers?
Ambetter was designed specifically to meet the requirements of:
What is Affordable Care Act (ACA)?
One of the goals of Member & Provider Solutions is to:
What is develop and administer innovative services, maintain and improve customer satisfaction?
The metal tiers offered in a plan:
What is Bronze, Silver, and Gold?
FFM:
What is Federally Facilitated Marketplace?