Medicare
This is the country's health insurance program for people aged 65 or older.
What is Medicare?
This plan started in 2016.
What is PHP GA?
A statement sent by a health insurance company to insured individuals explaining what medical treatments or services were paid for.
What is an EOB?
This system is used for 2023 claims and prior.
What is EZ CAP?
Where you would go to pull up benefits.
What is My Plan Documents?
This will always have a premium and it usually increases annually.
What is Medicare Part B
This plan has plans in CA, VA, FL & MI.
What is Align Senior Care?
This is the comprehensive resource guide to your health care coverage.
What is the EOC - Evidence of Coverage?
This system is used to check whether a check has been posted or cash.
What is Truist?
Best used for Plan comparisons.
What is the SOB - Summary of Benefits?
This is a supplemental Insurance Plan that Private companies offer.
What is Medigap Part F?
This plan name and plan abbreviation is the same.
What is NHC?
Also known as a prior authorization.
What is an Org. Determination?
What is NICE?
What is ISNP, DSNP and CSNP?
This usually will not have a premium, which only applies to people who have not worked 10 years before receiving Medicare.
What is Medicare Part A?
This plan's name abbreviation is the same as the R&B Singer who is dubbed the Princess of Hip Hop Soul.
What is KeyCare?
Curana Health plans do not have these.
What are group numbers?
This system is a repository that houses various member, provider and UM documents.
What is DMS?
This plan type is only offered to our LIS members.
What is a DSNP?
List the various Medicare enrollment periods.
IEP - Initial Enrollment Period
AEP - Annual Enrollment Period
SEP - Special Enrollment Period
List the three states this plan is provided in.
What is NHC MO, NHC TN, and NHC SC?
2 methods in which health care providers are paid for the services they perform.
What is Capitation and Fee for service?
These two systems were developed by TriZetto which is a Cognizant Company.
What is QNXT and My QNXT?
A member must pay these until they reach their MOOP
What are deductibles and coinsurance?