Cams
Ibaag
SOP
UHC products
UHC programs
100
Tab where members account balance is located
What is Membership/Accumulators
100
can you email the information in red to members
What is No
100
Instructions for emailing benefits
What is Navigator OneSource
100
what plan do networks NOT apply to
What is Indemnity
100
____ is a maternity wellness program designed to provide members with additional support, education and works with expectant moms to identify and manage high risk pregnancies and potential NICU patients before delivery.
What is Healthy Pregnancy Program
200
What are the 3 ways to search a member in cams
What is SSN//ALT ID with 2 zeros in front//name and DOB
200
Name 4 of the sectional bookmarks
What is benefits and limitations // chemical dependency // coinsurance // communication data // co-pays // deductible // family planning // flexible spending accounts // hospital services // maternity // mental health // other benefits // OOP // physician services // pharmacy // special services
200
provides a list of nationally contracted DME providers
What is National Ancillary Provider Job aid
200
PCP is only required for
What is Select/Select Plus plans
200
____ helps reduce complications and costs associated with weight loss surgery for morbid obesity. It includes a Centers of Excellence network, support and benefits guidance. Experienced nurses educate and guide consumers through a four-phase process designed to help individuals understand and manage conditions associated with morbid obesity before and after surgery, and to encourage successful weight loss through surgical intervention.
What is Bariatric Resource Services (BRS)
300
What number do you always subtract from the filing limit before you quote it.
What is 7
300
what tab in ibaag tells you if the plan is a calendar year or policy year
What is deductible tab // oop tab
300
provides a chart to tell you what you can and can't say to certain types of callers
What is HIPAA One Source
300
what 2 plans do NOT have oon benefits
What is Select // Choice
300
____ provides access to a Cancer Centers of Excellence network for financial savings and improved quality of care, short term clinical consulting services provided by experienced cancer nurses to help patients and/or case managers understand cancer diagnoses and treatments.
What is Cancer Resource Services // Cancer Support Program
400
What indicator in cams tells you the member has a physical card
What is purse enabled
400
what section in ibaag tells you if the plan has or hasn't been grandfathered in
What is Health Care Reform
400
provides you step by step (with picture) instructions through cams
What is CAMS interactive resource guide Job aid
400
How many of the plans that we service require a referral from their PCP
What is Zero
400
___ provides access to experienced, specially-trained nurses who inform members about evidence-based treatment guidelines and the associated risks, benefits and outcomes of different treatment options.
What is Treatment Decision Support
500
what section of cams provides you with the grace period if the account allows one.
What is General Settings
500
before checking a claims processing to the last years benefits what needs to be done
What is library search
500
provides a chart to tell you which pharmacies the flu/shingles shots are covered at
What is Vaccine benefits SOP
500
what are 5 managed care plans
What is Select // Select plus // Choice // Choice plus // CORE (a choice plus product)
500
_____ OptumHealth provides assessments and case management for End Stage Renal Failure (ESRD) patients – including dialysis, kidney failure, vascular access surgery, or related benefits.
What is Kidney Resource Services (CMC)
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