Claims
The team that handles Claims
What is Member Claims Associates?
Request for understanding why a claim processed a certain way
What is an Adjudication Explanation RT?
The superior team that handles communication via written word between members and Collective Health
What is the Messages Team, of course.
Services offered by Clients outside of traditional benefits
What is Program Partners?
The acronym for member submitted out of network claims
What is MSOON?
Request for confirmation of provider network status
What is Network Status Inquiry RT?
The team that handles all of our complaints about how we can't hear the member and then turns our volume on and humbles us daily
What is IT?
Mental Health Program Partners(2)
What is Headway, Doctor on Demand?
Request for over turning a denied claim
What is an Appeal?
Request for estimated costs for out of network services
What is an Allowed Amount Estimate?
The team that processes appeals, gap exceptions, out-of-network pricing, plan exception requests, and external reviews
What is Plan Policies (Plan Ops)?
Program Partner that offers support during and after pregnancy
What is Cleo?
Contracted rate between Provider and Network
What is Allowed Amount?
Request for INN claim submission for a provider that refuses to submit a claim
What is Provider Payments RT?
The Team that handles communication between Client and CH (NOT escalations)
What is Client Services?
Fertility related Program Partners (4)
What is Progyny, Maven, Carrot and Kindbody?