Billing
What billing process involves making an account inactive to active again?
Reinstatement
What does the abbreviation NIIA mean?
National Individual Insurance Agency
What is the turnaround time for a response from the HR or Payroll team?
24 Hours
As a TPA, what are 3 areas we service?
What is an EOB? And what does it mean?
Explanation of Benefits- Each time your insurer pays for a service you use; they send you an Explanation of Benefits (EOB).
What is an RDR?
Rapid Dispute Resolution- Visa chargeback prevention tool, that allows the merchant to automatically issue a credit to the customer/member.
Where are company policies found now that we are remote?
Adoptech Portal
Who is the President of AHCM?
Landon Jordan
Is it cheaper to stay in or out of network?
In network
How many Age Out reports are received for each month?
Three- First report is received 60 days prior to month in question.
Is a producer required to have a license to market and sell?
No, Jericho/JHS is not insurance.
Where do I go in Paycom to update my banking information?
Under ESS login the employee goes to Payroll tab. Selects "'Direct Deposit" and add/edit account.
Who is the CEO of AHCM?
Mike Sullivan
Does AHCM pay claims?
No, only Blackhawk pays claims or third-party carriers (ACI).
What is the time frame to generate and provide a paper invoice to our OP29 members?
Billing do NOT provide paper invoices.
When referring to a PPO Dental plan, list one service under Type II.
Fillings, extractions, or minor oral surgery
What is the definition of a Qualifying Life Event and how do employees submit these requests?
QLE is defined as an event that allows for changes on your current year elected benefits. An employee can submit a request for benefit changes under the ESS Benefits tab. By selecting "Qualifying Events" and Add new event.
When was AHCM founded?
Founded in 1983 by Dr. Rabie
Who determines the rates when a provider decides to join the network PHCS?
The provider
What is Ethoca and who is it owned by?
Ethoca is a platform owed by Mastercard and is enabling merchants to access fraud and transaction dispute data from card issuers in real time.
What does a 12/12 preexisting condition mean?
Any medical services resulting from a disease or physical condition for which medical advice, treatment or diagnosis was received and/or a prescription was prescribed, during the 12-month period preceding the member’s effective date are ineligible for 12 months after enrollment.
Are regular pay and bonuses taxed the same?
False. Since bonuses are paid in addition to your normal paycheck, taxes are withheld at a higher rate than your normal wages. This is because they are considered supplemental income.
What is required to enroll in our association plans?
Enrolling in an Association membership such as NAPP
Where does a provider submit a claim when a member has Galaxy Health?
No claims to submit, this is savings at the time of service.