Authenticate
What systems are used to authenticate a member?
What is Salesforce, HIX and MyWorkSpace (MWS)?
This eliminated preexisting conditions, allowed dependents under 26 to stay on their parents' plan, and eliminated lifetime maximums.
What is the Affordable Care Act?
(ACA)
A tool to guide agents through processes allowing them to select the correct steps based on their current interaction with the customer.
What is Guided Workflow
Our "sense of truth".
What is Health Insurance Exchange?
(HIX)
Web-based system created due to the ACA requirements and is used by the Health Connector and MassHealth to determine eligibility for health and dental plans.
(HIX)
Which Guided Workflow enables you to submit refund request and verify the cred amount listed on the invoice?
What is Billing and Payments
If the Head of Household does not have a social security number on file, what pieces of information can be used to authenticate?
What is the Subscriber ID and the full mailing address?
The U.S government provides these for households who's health insurance costs more than 8.5% of their household income.
What are Advanced Premium Tax Credits?(APTC)
Provides access to previously used solutions that have been used to resolve cases
What are Knowledge Articles
The HOH's name will always be listed first in this section of the Account Dashboard in HIX.
What is Latest Eligibility?
A change in circumstances that may impact an individual's or a household's eligibility for coverage or financial help on the exchange.
What is Qualifying Life Event?
(QLE)
What screen is used to help locate and properly authenticate callers?
What is Search and Authenticate?
This type of form allows a non-HOH to discuss a member account.
What is Permission to Share Information (PSI)?
-Certified by the Health Insurance Marketplace to provide Minimum Essential Coverage.
-Follows established limits on cost-sharing like deductibles, copayments and out-of-pocket maximums.
What is a Qualified Health Plan?
Each time a call is made in Salesforce, whether inbound or outbound, this type of record is created.
What is a Voice Call?