1
a fix amount made by an insured person towards the cost of medical treatment or other services
co-pay
Member can enroll their plan to COBRA from ____ months.
18 months
If employer files bankruptcy, the member will have COBRA coverage for _____ months?
remainder of their life
Members will receive the ID Card within ___ days from the day it was requested?
10-15 business days
the amount of money that the insured person must pay before their insurance policy starts paying for covered expenses
deductible
CPT Codes consist of __ digits and also known as ____ or _____
5 digits / Procedure Code or Billing Code
If the call is Auto-Pop and the member is not the same as the info showing, we will still assist the member without additional verification. TRUE or FALSE
FALSE
Maria, is John's mother. Maria is not part of the plan but only calling about General Info. Can we assist Maria?
NO! unless there is a Verbal Consent from John or Authorization on file.
is the most you will have to pay for covered healthcare services in a plan or calendar year. Once you reach this limit, your health insurance plan covers 100% of the costs for the remainder of the period for covered services.
out of pocket limit
Voluntold as the first Tribute for the next Mock Call.
GEW!!!
We ask verbal consent from the Subject if the Originator is calling about ____ .
Claims Info
the amount you pay to your insurer regularly to keep an insurance policy in force
premium
What are the 2 Self Service Options?
MYUHC Portal and MYUHC App
What is the FRAMEWORK we follow in quoting Benefits?
DELTAS
What are the information we can change on the member's plan?
Contact/Communication Preference Info
For members experiencing Social Determinants of Health (SDoH), which website we can refer them to for assistance?
You may sit but someone must stand again.
The who?
the percentage of covered health costs you're responsible for paying after you've met your deductible
co-insurance
Employers Name is also called as ______?
Group Name
DELTAS stands for?
DELTAS
What information do we ask the caller if the call is not Auto-Pop
Member ID, Full Name and DOB
Where in ACET we can send links to the member? Example: Portal Registration Link, Claim Submission Form, etc.
Quick Actions > EZcomm
TRUE or FALSE
COPAY will apply to both DEDUCTIBLE and OOP MAX
FALSE! OOP MAX only
If they wanted to enroll the plan to COBRA, they have to enroll the plan within __ days from the termination date.
60 days
spouse and/or dependent child has coverage for ___ months after death of retiree
36 months