Medicare Advantage
LIS AND RX
Week 4
Disenroll/Enroll
benefits
100
When a member becomes eligible for medicaid coverage they become eligible for an?

what is dual special needs program?

100

drugs and medication that by law require prescription ?

WHAT IS PRESCRIPTION DRUGS?

100

what does OOA stand for ?


what is Out of area ?

100

what is a standard election period? 

what is Annual Enrollment Period 

100

what intent is used for UCard OTC Benefits?

what is review medical benefits

200

What does Medicare Advantage plans cover?

what is Part A, B &D

200

Drug considered to have a strong potential for abuse or addiction and have a legitimate medical use?

what is a controlled substance?

200

what does SCC stand for ?

WHAT IS STATE COUNTY CODE?
200

"I recently lost my part B but I got it fixed 15 days ago , can you help me be put back into my plan?" this statement falls under what category?

what is reinstatement 

200

What is used the UCard used for ?

what is rewards, ID card for Doctors and Pharmacy, OTC , fitness, dental, vision and hearing.

300

A member must be with the plan how many months before receiving the CAHPS survey?

what is 6 months 

300

A prescription drug that is changed in some way to meet patient's needs such as going from pill form to liquid, getting a different dosage or adding a flavoring.

what is a compound drug?
300

If a member is unable to schedule a appointment with a provider what is your next step?

What is scheduling a commitment?
300

Annual Enrollment Period time frame ?

what is 10/15-12/07

300

How many times does UHC offer housecalls to go to the home?

what is 1 time ?

400

When is the first notification of CAHPS survey?

what is 02/28

400
Who do you contact regarding becoming eligible for LIS ?

WHAT IS SSA?

400

If a member agrees to scheduling a house call visit what is next ?

WHAT IS WARM TRANSFERRING TO HOUSE CALLS?

400

Open enrollment time frame 

what is 01/01-03/31

400

When should you warm transfer to house calls?

what is when a member agrees to schedule?

500

How old does a member have to be to obtain medicare ?

what is 65 years or older 

500

a request for the plan to cove a medication that is NOT included in the formulary is called...


WHAT IS A FORMULARY EXCEPTION?

500
How many time will a member need to register for healthsafe ID?

WHAT IS ONE TIME? 

500

What system is used to check application status?

what is MARx and Maestro 

500
What is used to identify risk and then mitigate those risk by referring the patient to the appropriate resource. 

what is Annual Wellness Visit?