Part D
MIIM
Billing
Benefits
A&G
100
You pay 100% of your prescriptions until its paid in full.
What is Deductible?
100
The category and intent used to send a member a replacement ID.
What is Member category and Send Non-marketing materials Intent?
100
We offer this when a member is behind at least 2 months on their payments.
What is Repayment Plan?
100
Your source of truth for benefits (2).
What is iBAAG and EOC?
100
A member complains about the hold music.
What is Verbal Grievance?
200
Members fixed cost share during the Initial Coverage Phase.
What is Copay?
200
The process of proving a member had credible presciption coverage.
What is LEP Attestation?
200
We need a written consent for these 2 Method of Payments.
What is SSA deduction and EFT?
200
Source of truth for the upcoming calendar year.
What is ANOC?
200
A member wants to have a benefit covered that is not included in their plan.
What is a Organization Determination?
300
UHC's formulary lookup website.
What is RxWeb?
300
You must refer the member back to SSI when completing this process.
What is Update Member Address?
300
EFT, SSA deduction, Monthly Bill, Online, and One-time payments.
What is 5 Method of Payments?
300
We use this Category and Intent to Review Medical Benefits.
What is Plan category and Review Medical Benefits intent?
300
A member wants to have a claim reconsidered.
What is Appeal?
400
Benefits for prescription drugs.
What is Medicare Part D?
400
This contains your name, date, and time you entered the information.
What is Notes/Documentation?
400
The 1st of each month.
What is the due date for all our plans?
400
We view PCP copay here.
What is Account Summary, Benefits tab?
400
A member wants to have a drug covered that is non-formulary.
What is a Coverage Determination?
500
Written by a doctor to treat a diagnosis.
What is prescription?
500
You go here when a member is on an extended vacation. (Category/Intent)
What is Plan category and Manage Passport Intent?
500
This is where we go to re-print a monthly bill.
What is EDSS?
500
An addition to a MA plan when your service area offers it.
What is Rider?
500
A member is upset that their bill keeps reading they are behind on their premium.
What is Verbal Grievance.
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