appeals
this type of appeal can be submitted verbally?
what is Pre-Service appeal?
when contacting COBR What pieces of information will be asked to provide to internal voice. Response IVR system?
what is 1-5 letters of last name / date of birth/mbi (Medicare beneficiary ID?
WHAT IS MBI?
what is MEDICARE beneficiary ID?
means a member's Medicare and Medicaid coverage is provided by the same company
what is aligned ?
when are member's premiums due ?
what is the first of each month?
What type of appeal is submitted via writing ?
what is Post-service appeal?
If a member has more than 1 presciption plan but it may cause?
What is Excessive Coverage?
FFS stands for ?
what is FEE FOR SERVICE?
means a member's Medicare and Medicaid coverage is provided by different companies or a FEE-for-Service (FFS).
what is unaligned?
how many days does it take for a payment to be processed for premium billing?
what is 3-5 business days?
when a member feels as if they have been incorrectly charged what type of appeal?
what is cost sharing dispute?
Which 3 methods can members with prescription drug coverage use to provide other insurance information ?
what is Enrollment form, follow-up survey (30 days after enrollment ) & over the phone via advocate?
what is COBR ?
what is coordination of benefits and recovery?
what options do member have for refunds ?
what is automatically or by members request?
" I did not like the cost of my copay!" what type of appeal request does this statement fall under?
What is a standard verbal grievance ?
Mr. Brown is calling in today regarding his new supplemental plan and needs to update his plan. what intent is used?
what is "Review Member's COB"?
what is NPOP
what is NON-payment of premium?
what standards are need to be followed when documentating ?
what is “Complaints, Appeals, and Grievances Intent” standards ?
the system we use to take credit card payments.
what is payment system payments ?
THE MEMBER BELIEVES THE WRONG AMOUNT WAS CHARGED
what is cost share dispute?
process for determining and processing a claim in conjunction with another insurance coverage.
what is coordination of benefits?
what does MOP stand for ?
what is method of payment ?
Email must contain specific template information, including:
what is Caller details, Case details, Any supporting information, Proper formatting & Correct routing instructions ?
what are the acceptable one time credit card payments that can be used?
what is visa, mastercard or discover?