HRA
Submitting claims for premiums
Documentation must have the following:
What is- Date of Service, Description of Service, Payment Amount, Name of provider, supplier, or pharmacy and Customer name, as well as what type of plan the premium is for.
Where are the instructions to create a SNOW ticket.
What is- FAQ's homepage
Indicative Data Change, where is this located in KIT.
What is- CRM>Customer accounts>Indicative data
Where is appointment management outlined in KIT.
What is - Kit>CRM>Appointments
What is Medicare
What is - Medicare is a federal insurance plan for anyone ages 65 and older, and some people who are under 65 with certain disabilities or conditions.
UPS retiree is trying to change direct deposit on the website. Where do you find the job aid?
What is- HRA & YSA-HRA- YSA- YSA Self-Service- Alight Worklife Access- Setting up Direct Deposit.
What does Incomplete at Carrier mean?
What is- FAQs-inbound call- Enrollment Statuses.
Something is missing and carrier has deemed it incomplete.
Prior to making any changes to indicative data make sure you're following the process for what.
What is -Authenticating the account
What should be the disposition when you create an appointment.
What is- Created new
How long is IEP
What is - 7 months, 3 months before 65th birthday and 3 months after.
What does HRA stand for?
What is- Health Reimbursement Account.
Retire says," I got a letter... " what should the agent do next?
What is- Ask probing questions
Indicative data changes may include
What is- New phone number, gender, change of address, updated name (including middle initial), new email address, death, divorce, etc
What is- Scope of Appointment
What are a few things Medicare dont cover
What is-
Cx claim was denied and the description says "Need EOB or Proof of No Insurance." What does that mean?
HRA & YSA-HRA Info in CRM- YSA Status Codes
An Explanation of Benefits (EOB) is needed to determine your out-of-pocket expense for this service.
The person I am talking to has a newly signed application that they have decided they no longer want to be sent to the carrier, what do you do?
What is- No case needed. Once the application is in VBA (Verified by Agency) it needs to be submitted, but the customer can contact the carrier after submission to request cancellation.
How can a retiree update indicative data for a spouse.
What is - Only update the spouse’s information if the retiree has POA or the spouse provides permission to update their account.
Is it a requirement to review Prescriptions and Providers when in appointment management.
What is- Yes (only not required for ancillary plans)
Verify the dosage and quantity, refill for every prescription. Verify the providers name and location.
What is Medigap
What is- A Medicare Supplement or Medigap is a type of health insurance sold by private insurance companies to fill the "gaps" in Original Medicare and are standardized* by the federal government.
Which new client has 3 different types of HRA's. What are the HRA categories?
What is- Wellmark
Annual, One-time , PreMedicare/ACA
I'm speaking with a customer that says they are missing a reimbursement.
What is- Check YSA claims page FIRST. Still unresolved, transfer to YSA.
What do you do if "indicative data" is not listed on the clients homepage?
What is- If Indicative data is not specifically mentioned on the list, choose the general phone number to call for indicative data updates and offer to transfer.
If one retiree is on the phone asking for a joint with their spouse:
If spouse is not there- Attach them to the appt to reserve the appropriate block for BA and notate the account they need to hear the SOA before appt begins
What is Medicare Advantage
What is- A Medicare Advantage Plan is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are Medicare-approved plans.