Systems
Used to generate a DSNP code
Salesforce
covers skilled nursing services
Part A
explains the Medicaid eligibility of the recipient.
DSNP reference guide
Can apply for LIS
Beneficiaries with limited income & resources who do not fall into one of the subsidy groups.
Meet income asset limits to
qualify for MSP
Used to locate the plans and contract codes
EPST (product and plan search tool)
covers clinical lab services
Part B
special hotline that agents and brokers can call, at the point of sale, to determine if their clients qualify
DVT validation line
Eligibility can be determined by
SSA, state Medicaid office
MSP stands for
Medicare Service Plan
Used by brokers
mProducer
Private Insurance company, approved by Medicare.
Part C- Medicare Advantage Plans
A survey mandated by Centers for Medicare and Medicaid Services (CMS) for new Medicare Advantage members within 90 days of enrollment
DSNP Health Risk Assessment
No late enrollment penalty will be received if
they qualify for extra help and join a Medicare drug plan
Age 65 or older and/or with certain disabilities
Medicare eligibility
To find transportation information
WDIG
Going 63 days without coverage can trigger a late enrollment penalty
Part D
Dual Eligible individuals may also be deemed eligible by their state. These are most commonly known as
Full Benefit Dual Eligibles (FBDEs)
SEP stands for
Special Enrollment Period
Requires 3 day hospital stay
Skilled nursing facility care
Every noun that we release and any question the agent asks goes in
Call Tracker
Delayed enrollment could mean 10% penalty
Part B
real-time, on-line, DSNP eligibility validation tool
MELA
A person entitled to Medicare and Medicaid
Dual Eligible
Begins, the day they are admitted into the hospital or skilled nursing facility and ends 60 days after discharge
Skilled nursing facility care