Show:
Ambetter
Week 1 Overview
Miscellaneous
CRM
Ambetter Payments
100
A commercial health insurance product with policies for both individuals and families.
What is Ambetter?
100
The Affordable Care Act _____ the number of uninsured Americans.
What is Decreased?
100
*************Daily Double**************** Open Enrollment Season for Ambetter starts:
November 1st- January 31st
100
How many tabs you must open in order to complete a phone call?
What is 4 tabs.
100
*************Daily Double**************** How many forms of payments Ambetter accept? What are they?
5 ways. 1. IVR 2.ONLINE(member portal) 3. OVER THE PHONE 4. MAIL IN PAYMENTS 5. MONEY GRAM
200
Emergency Services Outpatient/Ambulatory Services Preventive & Wellness Services Maternity & Newborn Services Pediatric Services Mental Health & Substance Abuse Services Laboratory Services Prescription Drugs Various Therapy Services (PT & Devices) Hospitalization
What is 10 Essential Benefits of ACA?
200
To enroll for coverage through the Health Insurance Marketplace you must be:
What is not incarcerated, lawfully present, living in the state where you are the purchasing the plan.
200
Optional Vendor Services for Ambetter are
What is Dental and Vision they are buy-up options; (cannot buy dental only)
200
How do you close Tab 3 once you have completed the phone call?
What is Close?
200
Member's have how many days to make their premium payment without APTC.
What is 30 days?
300
Monthly bill that a member has to pay to have insurance and a member must pay this before they are covered.
What is Premiums?
300
************DAILY DOUBLE*************** This is a system we use to gain more knowledge and learning on Ambetter and Centene information.
What Q-Mindshare and Cornerstone Learning.
300
Member HIPPA verification requires that you verify (how many) pieces of indentification? What are they?
(3) Three pieces of HIPPA verification; examples: Full name or Date of Birth and Address&Phone Number, Social (last4) and Member ID number?
300
A member or provider who is not yet loaded into the system.
What is Alternate Contact?
300
Member's with APTC have how many days to make their premium payment?
Up to ninety (90) days.
400
******************DAILY DOUBLE***************** List the Health Plan Choices for Ambetter.
Essential Care (Bronze) Balance Care (Silver) Secure Care (Gold)
400
This system is used to process payments
What is e-cashier Emdeon?
400
All tiers can quality for premium subsidies which is:
What is Advanced Premium Tax Credits (APTCs)>
400
Where in CRM do you find the Member Care Gap?
Within Tools, then under the members Member Care Gap.
400
Can a wife calling in on the husband's account pay for the premium with the husband's card?
No, The card must match the person calling in to make the payment.
500
Cost Sharing consist of the following:
What is Deductibles What is Co-pays What is Co-insurance
500
This is where you would search for educational updates on Ambetter.
What is SharePoint and the Web Portal?
500
************DAILY DOUBLE************** To Provide better health outcomes at lower cost
What is Centene's Mission statement?
500
The system we use to document all of the member's information.
What is CRM?
500
Members are not considered enrolled until they make their:
What is first time payment or binder payment.