Member's wife calling about a bill
PHI/AOR not found in OMNI
What is FileNet (OCOE), TruCare Cloud
CP: Authorized Callers, Non-Authorized Callers, Power of Attorneys, Medical Power of Attorneys, and Legal Guardians (https://cenpointprd.ad.wellcare.com/articles/3e8d8ab6-d471-4f6e-866d-25452cb9605e)
Moved 2 weeks ago & no Plan mail received
What is OMNI?
CP: OMNI 3.0 Update Member Demographics Process (https://cenpointprd.ad.wellcare.com/articles/fb18ae7f-5397-4f87-84ae-5d5ffd39cad4)
*What important question should you also ask the member about their address?
Amisys
What is:
Find a Claim (by member or claim number)
Provider Par Status
Accumulator Status (MOOP)
Verifying Check Info
Scheduling Transportation; Texas
Vendor: ModivCare: Contact: Reservations (72 hours in advance): 877-718-4201 (https://cenpointprd.ad.wellcare.com/articles/3a8de57c-20a2-4664-8c99-ef331a3e1246)
Process: General Transportation Inquiries (https://cenpointprd.ad.wellcare.com/articles/ea448d27-eba3-45fb-98bf-3d2b5700791e)
No Claim Found in OMNI, I will check...
What is FileNet_OCOE?
CP: OMNI Claims Inquiry - Medicare (https://cenpointprd.ad.wellcare.com/articles/91e1f358-4531-4de7-bfe1-1261ec3b458b)
Hearing Aid appointment, Mississippi
OMNI - B&E Intent
CP: OMNI Benefits and Eligibility (https://cenpointprd.ad.wellcare.com/articles/d11d2dcb-db1c-45a1-ba9b-72afd908e89a?memory=80793)
Hearing Aids Medicare Contact and Resources (https://cenpointprd.ad.wellcare.com/articles/0342719d-6dee-483c-b407-5eec46e3349c)
* Vendor * - Hearing Care Solutions: 866-344-7756
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What is Portico?
Marx
What is:
Member Eligibility (including LIS, LEP, etc)
Verifying Member Demographics
Verifying Member's Health Plan
SSBCI - Eligibility - 2 Ways
CP: SSBCI Special Supplemental Benefits for the Chronically Ill (https://cenpointprd.ad.wellcare.com/articles/3f2865d1-e93a-4799-99fa-5ac089a6b4cf?memory=60576)
Sections:
Verifying Member Eligibility for SSBCI Program
Claim Found, additional information needed
What is Amisys?
CP: Viewing Claims in Amisys (https://cenpointprd.ad.wellcare.com/articles/3ab4ad25-df34-4213-8a07-994548089024)
Lisinopril Oral Tablet 10mg
What is the Plan Website; Formulary Search Tool (https://wellcare.magnoliahealthplan.com/drug-pharmacy/formulary/formulary-search-tool4.html)
Image 3
TruCare Cloud
Portico
What is:
Verifying Provider PAR status
Verifying Provider Hat Code
* to confirm a provider's PAR status what additional information do you need from the Members plan? (Carrier Code)
SSBCI - Benefits, California
CP: Special Supplemental Benefits for the Chronically Ill (SSBCI) Vendor Contacts and Resources (https://cenpointprd.ad.wellcare.com/articles/da8b8eb0-09d5-4adb-a5bc-10f186cb0b97?memory=63266)
Flex Cards/Utility Benefit
WEX Health
Helper Bees Customer Service
Joy for All Customer Care Line - Robotic Companion Pet
CP: Checking Claims Status in Amisys
(https://cenpointprd.ad.wellcare.com/articles/fabc8b0b-b211-4ba2-aca1-fe3c0bef0c9d)
Concerned about falls
OMNI: B & E Intent
CP: Personal Emergency Response System (PERS) Medicare Contacts and Resources (https://cenpointprd.ad.wellcare.com/articles/3811ea86-bac4-4d7c-881c-102085714a76?memory=63609)
*VRI: 800-860-4230 option 2 https://WellCarePERS.com/
Image 4
Amisys
FileNet
What is:
Med_Enroll - enrollment documents (HIPAA Auth; Enrollment, Disenrollment Applications)
OCOE - various documents sent by Plan, CMS or received by Member
Claims - images submitted by Provider, Reimbursement Forms from Member
CP: Using FileNet - Medicare (https://cenpointprd.ad.wellcare.com/articles/b8bdb6e9-031b-4ea7-8575-f4b9aff176f8?memory=77980)
3 Fitness Benefits
CP: Fitness Benefit (https://cenpointprd.ad.wellcare.com/articles/8f979ec5-2a69-4177-a714-d32738e3484b?memory=44013)
Silver & Fit (ASH)
PeerFit
Tivity (SilverSneakers)
Maximum Out-Of-Pocket (MOOP)
What is Amisys?
CP: Amisys Navigation (https://cenpointprd.ad.wellcare.com/articles/e8c63c0c-c2b9-4043-b26e-9152ddbf9ee5)
Image 5
File Net
Market Prominence
What is:
Viewing Billing, Payment, LEP, LIS and Enrollment Application Information
(https://cenpointprd.ad.wellcare.com/articles/3188c26b-cb54-4465-8ea6-6e31ecb53f9a?memory=50080)
Pharmacy Claim Denied
What is CVS/Caremark?
CP: CVS Caremark Client Care Access (https://cenpointprd.ad.wellcare.com/articles/46d868e2-0968-45a0-9e07-e48f6eae3088?memory=51162)