Medicare
How long does a bene have to enroll in Medicare?
What is 7-months. 3 months before the month you turn 65, the month of your birthday and ends 3 months after the month you turn 65.
This is where you would go to check for authorization
What is Authorizations view ?
Covered or Non-Covered :
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What is Non-Covered?
This Social Security Administration database is the primary source of beneficiary information.
What is MBR – Master Beneficiary Record ?
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Who is Diamond?
Medicare pays all covered costs during the first 60 days
What is a benefit period?
If the caller does not enter any information into the interactive voice response (IVR) system, where do you go in Next Generation Desktop (NGD) to open the call?
What is the BCC Tier 1 screen ?
Pays for Most medical costs and prescription drugs costs.
What is Medicaid?
This Medicare database provides an interface between the Centers for Medicare & Medicaid Services (CMS) and the claims contractors.
What is CWF – Common Working File ?
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Who is Donna ?
coinsurance
What is amount for a hospital inpatient stay per day ?
Emily Davis calls on behalf of her grandmother. She passes disclosure with you and says she is calling about a recent claim. Her grandmother is not available, and there is no authorization on file, but Emily does have the Medicare Summary Notice (MSN) for the claim.
This is the information should you update in Next Generation Desktop (NGD) before continuing.
What is You should update the Caller Name and Caller Relationship fields in the Activities list applet.
You’re under age 65 and have been entitled to disability benefits from the Social Security Administration or the Railroad Retirement Board for 24 months.
What is Eligible for Medicare due to disability ?
If an error occurs on a system you need to overlay
What is escalate to the Advanced Resolution Center (ARC) ?
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Who is Jody?
Mr Johnson is new to medicare, He calls 1-800 Medicare to ask when he will receive his red white and blue medicare card.
What is You will receive your red, white, and blue Medicare card in the mail 3 months before your sixty-fifth birthday.
This is how a bene has to enroll into Medicare
What is 7-month period that starts 3 months before the month you turn 65, the month of your birthday and ends 3 months after the month you turn 65.
The time period before you receive a delinquent Medicare bill.
What is 90 days after your first bill. ?
This Medicare database contains information for all beneficiaries and includes demographic information, enrollment dates, Medicare card information, and MSN and handbook format and language preferences.
What is BIC – Beneficiary in the Cloud ?
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Who is Willie Jones (John Witherspoon) ?
A call comes through the interactive voice response (IVR) system on April 10, 2021. Melissa takes the call and uses the greeting, “Thank you for calling Medicare. This is Melissa King. How may I help you today?” The beneficiary responds, “I need to know if I have Medicare Part B and if it will cover acupuncture.” Melissa asks the beneficiary for her first and last names and then searches for a script to answer the beneficiary’s question. Melissa confirms the beneficiary’s Part B coverage. What keywords should Melissa use to search for the correct script?
What is
Acupuncture
Part B coverage
Services
Christopher Brown calls 1-800-MEDICAREto find out more about his Part A and Part B premiums. He would like to know how much he currently owes for his Part A and Part B premiums.
Use this view to answer Mr Browns questions
What is Premium summary?
The time period a bene has to enroll into Medicare after their employments ends.
What is 8 months. It starts when the employer or union group health coverage ends or when the employment ends, whichever comes first. ?
Even though you’ve already contacted Social Security or updated your record online using your my Social Security account, your record may not be updated in our system yet. You will need to wait for the update to go through. If it has been longer than _____ please call Social Security again.
What is 30 days ?
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