Systems
Hospice dates are found where?
Facets
What is the routing group for the mailing room?
bg-cc02
Healthnow accepts what kind of appeals?
Written
Claims are submitted this way.
Paper
Electronic
In content navigator PR stands for what?
Patient Responsibility
What system is used to take check and credit card payments over the phone?
InstaMed
Mbr Claim Adjustment routing group is ?
bg-cc05
If a member calls and states they "need" or "want" a service what is it considered?
Org/Coverage Determination
ARC 1 stands for?
Deductible
My Advocate can help members make doctors appointments.
False
To determine if a procedure code is covered you would go here.
Code and Comment
What is the routing group to route something to your self?
bg-cc01
In what tab would you look to see if a member has filed a grievance?
Appeals
What is the quick key to pull up the claim search box?
F3
If a benefit is not covered what should we offer the member?
Health Navigator
What system do you use to research the payment status of a member payable check?
UCDS
If a Medigap member calls and wants to make name changes you would create and inquiry and route it where?
bg-mb01
Who can file a grievance?
Member
POA
AOR
Executor
How do you know if a claim has been adjusted?
The claim number would end in 01, 02, etc.
Each year, the Annual Enrollment Period is...
October 15th - December 7th
What system(s) are used to find claims?
Streamline
Pega
LRG
What is the routing group for G & A?
gp-cc05
What's the subject if the member states the staff was rude?
Med Adv Griev/Complaint
What type of claim format represents a paper form submitted by a provider for services in his office?
CMS1500
People who qualify for “Extra Help” (Low Income Subsidy) are allowed to enroll in, or disenroll from, a Medicare Advantage plan once per calendar quarter during the first nine months of the year.
True