Systems
I am your main system to document calls
Maestro
If I am SLMB+, will I owe a copay/coinsurance/deductible?
No
How many identifiers do we need for HIPAA?
3
Where can I find the member's PCP?
On the summary screen under the PCP tile
or under the Plan tab
What does INN mean?
In network
I am your source of Truth for Medicaid
MARx
I'm shown as "01-Partial Medicaid" in Maestro, yet I still pay for copays, coinsurance, deductibles. What Level of Medicaid am I?
QMB
What are the 2 identifiers we MUST get to verify HIPAA?
Name
DOB
Where can I find the Member's Medicaid Level?
On the Summary Screen on the Healthcare Plan tile
Do IN DSNP Plans have out of network benefits?
Yes, they are PPO
I am a site filled with knowledge, houses SOPs, and will be your best friend
Knowledge Central
If I am QI, should I expect a bill from a provider?
Yes
Is a caregiver the same as a Authorized rep
If a person is labeled as just a caregiver can we give them info on the member's account w/o the member's permission?
No
No
How do I know if the member is aligned?
There are green pages on the Member Banner
What is the site name that we can use to find Plan eligibility (what qualifies them for the plan) and other information relating to the certain contract number?
DSNP Toolbox
I will tell you the member's MCO for their Medicaid
DMEVs
Name the levels of Medicaid that are Full Medicaid
SLMB+
QMB+
FBDE
What is considered Basic Plan Information
Anything the public can access
Where do I find the Member's Medicare Claim ID?
Under the Member tab
Are IN DSNP plans aligned as of today?
NO
will possibly be on 7/1
I am the site you use to complete Health Assessments
ICUE
Name the three Partial levels of Medicaid
SLMB Only
QI
QDWI
Can a Power of Attorney change a member's address?
Yes with appropriate paperwork on file
Where would I find previous notes from previous discussions with the member?
Recent Interaction tab
What form do we fill out if a member wishes to cancel his plan before the effective date?
EWD