Enrollment
The enrollment period that starts on January 1st and ends on March 31st.
What is Open Enrollment Period?
This is where you can access a ton of information and begin a bunch of workflows.
What is Menu Navigation?
This is the document you use to quote benefits from.
What is the evidence of coverage?
This system is the main system that is used by CSRs.
What is GPS?
This stands for place of service.
What is POS?
The request to leave a plan before its effective date.
What is a cancellation?
You need these to close a case.
What is case comments and service requests?
This is how a bone density scan is quoted in the Evidence of Coverage.
What is bone mass measurement?
This system is used to view grievances and appeals.
What is MedHok?
This is the date that the member has the services rendered.
What is the date of service?
The member can only be uncovered for Part D for 63 days before this happens.
What is the late enrollment penalty?
This is where you find all things Medicare.
What is 'Medicare Attributes'?
You use this to quote non-emergent transportation benefits.
What are one- way trips?
This system is used mainly for claims.
What is HRP?
This code describes the service or equipment that the member receives.
What is the procedure code or CPT code?
This is an disenrollment that the member did not request.
What is an involuntary disenrollment?
Clicking this will bring up the "Membership" screen.
What is the 'Policy Name' hyperlink?
You should quote this when providing specialty benefits.
What is the referral requirement?
This system houses links and helpful resources.
What is the Wiki Tool?
This claim tab in HRP will display the message codes which includes important information such as denial reasons.
What is the 'Lines' tab?
What is the special election period?
This service request will start the grievance workflow.
What is Complaint/Appeal/Authorization?
This is how a MRI is listed in the 'Benefits section of GPS.
This system houses authorizations and case management information.
What is MedCompass?
This claim tab in HRP will display who has worked on the claim.
What is the 'Audit Log' tab?