Metal Tiers
Member Liabilities
Branding
Intents
Systems
100

Bronze plan

What is Ambetter Essential Care plan.

100
Share of cost that is a specified flat fee for a service.

What is a copay / copayment ?

100

Arizona

What is Ambetter from Arizona Complete Health?
100

"I'd really like to let someone know about the great service I've received today."

What is the Compliments intent?

100

System used for documentation.

What is Omni?

200

Silver

What is Ambetter Balanced Care plan?

200

Cost sharing that is a percentage of the covered services.

What is Coinsurance?

200

Florida

What is Ambetter from Sunshine Health?

200

"I need to make a premium payment today."

What is the Billing Inquiry and Payments intent?

200

Source of Truth for Provider information.

What is Portico?

300

Gold

What is Ambetter Secure Care plan?

300

Amount an insured person must pay before insurance begins to pay. 

What is Deductible?

300

Texas

What is Ambetter from Superior Health Plan?

300

"My husband and I just found out we are pregnant."

What is the Notification of Preg/Newborn intent?

300

Source of Truth for Claim information.

What is Amisys?

400

What plan is known for its extra savings.

What is Silver plan?

400

The most you have to pay for covered services within the plan year.

What is MOOP / Maximum Out Of Pocket?

400

Washington

What is Ambetter from Coordinated Care?

400

Member calling, his dog ate his ID card... HELP !

What is Order ID Card intent?
400

Source of truth for Authorization (medical) information.

What is TruCare Cloud?

500

Plan that offers highest OOP expense and lowest premium.

What is Bronze plan.

500

An out of pocket expense that is not considered share of cost.

What is Premium?

500

HealthNet

What is California?
500

Member calling in to see if we received a claim from their pharmacy. 

What is Pharmacy Claims Inquiry intent?

500

System used for evaluations and testing.

What is QMindshare?