HAMBURGERS
Information that can be used to identify, contact or locate a specific individual
What is Personally Identifiable Information (PII)?
This is the number assigned to identify that the claim came from another state
What is the SCCF number?
Information that can be used to identify, contact, or locate an individual.
What is PII or Personally Identifiable Information?
This occurs when a member has multiple insurance health plans that have to work together to avoid paying the provider too much money
What is coordination of benefits?
This vendor authorizes services such as CT Scans, MRIs and PET scans
What is Carelon?
This is the substitution of one person or group by another in respect to an insurance claim
What is subrogation?
These are the three Walmart Plan types
What is the Premier, Contribution and Saver Plans?
This is the method Walmart uses to coordinate benefits
What is the non-duplication method?
This plan includes a spending card where members can choose which provider they want to reimburse
What is the Saver Plan?
This link will show you how much is applied towards the deductible, out of pocket, and if a limited benefit has been used
What is the Accumulator link?
The place where you can view the QA manual and other processes and procedures
What is IOKB?
You can use this number to authenticate a call if the caller misses a required piece of information
What is the last four digits of the member's Social Security Number?
This vendor reaches out to the member and helps them with mild cases of stress and anxiety
What is AiRCare Health?
A provider that does not agree to participate in an insurer's network
What is an Out-of-Network Provider?
You can use this link to research a member's benefits, verify codes and see benefit scripts
What is Scripts and Codes?
The account employers set up for employees to reimburse some of the member's out-of-pocket expenses
What is Health Reimbursement Account (HRA)?
This department handles premium payments, reinstating coverage and court orders
What is Walmart People Services?
This plan consists of copays for PCPs, specialists and Emergency Room Services
What is the Premier Plan?
This resource helps you with knowing what questions to ask based on the member's prefix to determine the type (INN/OON) of benefits to give
What is the Select Network Chart?
This website allows the member to change their address, add members to their plan and enroll in coverage
What is one.walmart.com?
The name of the system where callers can enter their information and reason for the call
What is the Five9 IVA?
The PPO network for Arkansas Members
What is True Blue PPO?
Examples include HIV status, Mental Health Status, Pregnancy Status, Gender Identity treatment and Sexual Abuse Counseling
What is Highly Sensitive PHI?
You use this to document a new reason and result for the same call reference
What is Same Reference, New Case?
This is a resource members receive and answers questions about eligibility, enrollment, plan structures and more
What is the Summary Plan Description (SPD)?