It is deficiency in a person's memory,orientation,reasoning or judgment
What is Cognitive Impairment?
100
An institution primarily engaged in providing, by or under the supervision of physicians, inpatient diagnostic and therapeutic services
What is Hospital?
100
It is a coordination of benefits where LTCI Can reimburse for co-pays & deductibles
What is Partial Duplication?
100
They work to gather the information/documentation requested by CM/PS
What is Admin Team?
100
One of the Payment Auditor/QA of LTC Claims Payment MNL.
Who Jacq Junco?
200
It consists BP, DB, EP, and Inflation Protection Option
What are Core Benefits?
200
It primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing or rehabilitative services but does not provide the level of care or treatment available in a hospital.”
What is Skilled Nursing Facility?
200
These are health plans run by Medicare-approved private insurance companies (like an HMO or PPO), that covers hospital insurance and medical insurance
What is Medicare Part C (Advantage Plans)?
200
reviews clinical information and/or documentation to determine Benefit Eligibility (BE)
What is CM (Care Manager)?
200
The previous job Edsel before Manulife
What is bank teller?
300
These are considered necessary to keep one alive
What are ADLs (Activities of Daily Living)?
300
It is a temporary relief of the primary informal caregiver
What is Respite Care?
300
It is a joint Federal & State program that helps pay medical costs if you have limited income and resources and meet other eligibility requirements
What is Medicaid?
300
Evaluates the bills/invoices from the Providers, Process WOP
What is BS (benefit specialist)?
300
Total # of BS in LTC Claim Payment in Manila.
What is 41?
400
It is an addition to a policy that becomes part of the contract and expands or change the benefits payable
What is Rider?
400
These are facilities are for people needing assistance with Activities of Daily Living but wishing to live as independently as possible
What is ALF (Assisted Living Facility)?
400
It can be no-duplication,partial duplication, or completion duplication
What are Coordination of Benefits?
400
The step that involves the units in the life of the claim
CM
PS
Admin
BS
What is Ongoing Management?
400
The first LTC team of your trainer (Joy) before LTC Claims Payment Proc?
What is LTC Claims CC?
500
This is the # of days in a period of care where the PH must be eligible for, and pay for the eligible LTC services, before the policy begins paying.
What is Elimination Period (EP)?
500
It provides palliative care for a terminal illness
What is Hospice Care?
500
It impacts how the LTCI will pay?
What is Medicare?
500
BE (Benefit Eligibility) + PE (Provider Eligibility) =