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100
An agent is a liaison between what 3 main groups of people?
What is members, providers and health plan
100
Who is the account manager
What is Kirk Ragbir
100
what time does class start
What is 7am
100
What time does your account open at teleperformance?
What is 8am
100
How much is coffee in the break room
What is ten cents for the nasty coffee
200
What is an EOP and who gets it
What is Explanation of payment, Doctor or who filed the claim
200
The participant in a health plan (including their eligible dependents), which make up the plan’s enrollment
What is Member
200
The process of registering with a health plan threw the marketplace.
What is Enrollment
200
In the video what was Tony's Job
What is School Custodian/Janitor
200
Branding- What shade of color is centene in the marketplace.
What is Raspberry
300
True or false We get calls from members, family members of the member, medical assistants, clinics, doctors, law enforcement, churches.
What is True
300
The package of programs and services contractually agreed to between the state and the managed care organization.
What is The Health Plan
300
Status of a individual who has not made their first premium payment.
What is Pre-Member
300
where is Centene's headquarters?
What is St. Louis, MO
300
A person’s status with regard to whether they are allowed to participate in a health plan
What is Eligibility
400
How are MCO's Structured?
What is In four parts: 1. claims 2. medical management 3. provider networking and operations 4. service operations
400
Group of healthcare providers with whom the managed care organization negotiates payment rates
What is Provider Network
400
What is the reason we want to catch the members medical issues early
What is better health outcomes at lower cost or the company does not have to pay for high cost treatments when symptoms are caught early
400
Who is your trainer
What is William
400
Why does Centene believe "local is better"?
What is we employ local officers and staff in each state where we operate
500
Sabor Latino goes to the doctor for a broken toe and has not met his deductible of $250. The doctor orders bloodwork, a MRI, and places a stint on the foot. The doctor visit is $15, bloodwork is $85, MRI is $1500, stint is $400. Sabor Latino has a co-insurance of 20%. From this example what is sabor latino financial responsibility to pay?
What is $347
500
Sabor Latino goes to the doctor for a broken toe and has not met his deductible of $250. The doctor orders bloodwork, a MRI, and places a stint on the foot. The doctor visit is $15, bloodwork is $85, MRI is $1500, stint is $400. From this example what is sabor latino financial responsibility to pay?
What is Based off the given information Sabor Latino is responsible for $2000, from the information it does not state any co insurance or MOOP
500
Sabor Latino goes to the doctor for a broken toe and has not met his deductible of $250 and has a 20% coinsurance and a MOOP of $1700. The doctor orders bloodwork, a MRI, and places a stint on the foot. The doctor visit is $15, bloodwork is $85, MRI is $1500, stint is $400. From this example what is sabor latino financial responsibility to pay?
What is $60
500
Sabor Latino goes to the doctor for a broken toe and brought his son Nino Sabor jr. Sabor has not met his deductible of $250 and has a 20% coinsurance and a MOOP of $1700. The doctor orders bloodwork, a MRI, and places a stint on the foot. The doctor visit is $15, bloodwork is $85, MRI is $1500, stint is $400. From this example what is sabor latino and Nino Sabor jr financial responsibility to pay for their Deductible?
What is $500
500
Sabor Latino goes to the doctor for a broken toe and has not met his deductible of $250 and has a 20% coinsurance and a MOOP of $1700. The doctor orders bloodwork, a MRI, and places a stint on the foot. The doctor visit is $15, bloodwork is $85, MRI is $1500, stint is $400. Sabor received a invoice from his doctor and called you because he does not know why he got the invoice since he has insurance and paid his copay. Explain why he got the invoice?
What is Sabor is responsible for the copay of $15, He has a deductible of $250 and is responsible for 20% of charges after he meets the deductible until he reaches a total out of pocket value of $1700 for medical services
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