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(2minutes)

Using Claim ID EZACY9HGR , what is the DCN number of the Reimbursement Request ?


DCN - 220809111473

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What state is MT ?

Montana

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wala na kong maisip ๐Ÿคฃ

so , what is Malus ?

Malus is a genus of about 32โ€“57 species of small deciduous trees or shrubs in the family Rosaceae, including the domesticated orchard apple, crab apples and wild apples. The genus is native to the temperate zone of the Northern Hemisphere.

-Wikipedia  ๐Ÿคฃ ๐Ÿคฃ ๐Ÿคฃ

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Using E2FC0JH29 - who is the attending physician of the member ?

Jonathan Palmer

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Using Medicare ID6EV6XP7XQ66 , please provide the coverage for 2023 diagnostic procedure and test. 

INN - $40 copay for each Medicareโ€‘covered diagnostic procedure and test.

OON - 35% coinsurance for each Medicareโ€‘covered diagnostic procedure and test. 

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(HRP) Using 101797534200
Member can still maximize and use her MOOP ?

YES or NO? and Why ??

NO

- plan of the member is already terminated
Coverage Period= 06/01/2024-06/30/2024

 

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101854418800 - What is the dental provider of the Member ?


Liberty Dental - always check EOC of the member

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Please explain the use of
DME NATIONAL PROVIDER LIST 

DME List is use to check or to see INN provider for DME items .  

But if the member is under a PPO plan , they can see OON provider as long as it is ordered by the provider so they can coordinated it to the supplier to contact Aetna about the process.  

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What are the activities that Member can complete to have a Healthy Rewards Gift Card ?

with the rewards amount ..

Annual Wellness or Physical Visit - $25
Healthy Home Visit - $50
Diabetes Care - $30
Flue or Covid Shot - $15

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TAT for Appeal

Nice ๐Ÿ‘๐ŸŽ‰๐Ÿ‘๐ŸŽ‰

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What is the use of Website ?

PERFECTiONS ! ๐Ÿ‘๐ŸŽ‰

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What year did the original Toy Story Movie come out?

Toy Story (1995)

Toy Story, the first film in the franchise, was released on November 22, 1995

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What is Life station / life alert item ? please explain :)

personal emergency response system to help our member in case of emergency 

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Using Mainframe/EPDB tool , check the information of the providers name with the NPI No. 1194289702 

Provider Name :  Barron, Joseph R., DC 

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โ€œTanggap ko na Jane, Wanda, na talagang wala na akong lalaking makikita.โ€

- who is the actress?

โ€“ Doris (Rufa Mae Quinto)


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What is the NET ID of the provider ?

BAIG, AYESHA DMD

368 West Washington Street East Peoria, IL 61611

(309) 694-4444

Policy Name - Aetna Medicare Premier Preferred (HMO)

NET ID 01917 (In Network)

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what information's we can check in "Case Information" ?

Case Information
> Case Number
> Case Origin
> Subject
> Case Owner
> Caller Name 

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Please explain the use of GPS

Correct ! ๐Ÿ‘๐ŸŽ‰

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Gift Card Vendor - provide atleast 4 

Albertsons
CVS
Home Depot
Subway
TJ Maxx

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Status of E737CZ123 and member responsibility ?

Status - Final

Member Responsibility - $40.00  Co-Pay

9999

(GPS)
Name :  PHYLLIS M KROGER
DOB : 12/30/1952
ADDRESS : 1387 OAKMONT CT, MESQUITE, NV, 89027, US. 


What is the premium amount, and why member needs to pay it ?

Monthly Premium - $2.40

premium for LEP Amount

9999

Please explain what is "Medicare Part A,B,C and D" 

Yeehey ! Galeeng ๐Ÿ‘๐ŸŽ‰ ๐Ÿ‘๐ŸŽ‰

9999

What is LIS ? and please explain .... 

EeyYyyY ๐Ÿ‘๐ŸŽ‰  Ligtas kana sa mock call

9999

What is Signify Department ?

Assistance for the Health Home Visit inquiry 

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What is the use of case comments ?

Correct ! 

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