CCD
This is where we can view their spending summary and what has applied towards their oop max and/or deductible.
What is in the Medical Dropdown under Spending Summary?
What does LEP stand for?
What is Late Enrollment Penalty?
This is where you check for preventive services due for members
What is MPG Tool --> Gaps in Care?
What parts of Medicare does someone have to have to qualify for a Medicare Advantage plan?
What are Parts A&B?
This is what we need to include at the end of every Medicare call to summarize.
What is Medicare part C or D resolution?
This is the name of the section or area in CCD where we can update personal information such as gender, paperless communications, phone numbers, and other preferences.
What is The Preference Center?
What is EOC stand for?
What is Evidence of Coverage
This is the system we take member payments
What is ACI?
This is the preferred brand of Diabetic Glucometers and Supplies that are automatically covered.
What is LifeScan or Onetouch?
What is Enrollment/Eligibility.
This is where we can see when the last ID card was ordered.
What is the view member ID card under Medical Dropdown?
What does ESRD stand for?
What is End Stage Renal Disease?
This is where you can view member invoices
What is CCD or Filenet?
If someone is being involuntarily terminated due to non payment of premium, they have ONE chance to file a what?
What is a Good Cause Reinstatement?
This topic is used to update a PCP.
What is Provider/Network (updated PCP)
Where can we find the member's LIS level?
Subgroup, LIS Grid, EMMA
What does AOR stand for?
What is Appointment of Representative?
This is where you can view appeals and grievance information.
What is Medhok?
To view a member's EOC, we can search KIP by using what information?
Two different answers are acceptable.
What is PBP or Plan Code?
What code do you use after submitted a Coverage Determination?
What is RXF800?
The member's ID number with Original Medicare, is know as _______ in CCD.
What is the Alternate ID?
What does IRE stand for?
What is Independent Review Entity?
This is where you can view letters related to enrollment.
What is EMMA?
If a member disagress with their LEP, they can appeal with the IRE. Who is our IRE?
What is Maximus?
This topic is used to document that you submitted an Organization Determination?
What is Benefits (ODAG)