What needs to be done before you can update the PCP on the PAMG screen?
PATR (if you don't PATR it don't matter)
100
What is the amount of time given by CMS to submitt 4Rx
72 Hours
100
What is the letter called if a member is rejected and not accepted on any plan?
MEO 212 or 213 aka On your own letter (OYO)
100
What is the amount of time an associate has to Rebutt a bad QA score ?
5 Days
200
What are the 2 types of ICEP
Routine & Non Routine
200
What screens are needed to valid contract and pbp for a group plan?
RVXR
GBDM
200
What are the 4 enrollment source codes for auto assigned or facilitated enrollments?
C, A, R, X
200
What system not screen is used to see if a letter was sent?
EMME
200
What are Humana’s RX Bin and RX PCN?
015581 and 03200000
300
What is the eletion type used for institutionized members and what ETC do they use?
OEPI - T
300
What does BEQ stand for and what screen is it retriggered on?
Batch Eligibility Query and PCCV
300
What is the time frame to enroll/disenroll in an OSB plan?
No time frame you can enroll/disenroll anytime from an OSB
300
What are the 3 ways letters can be sent?
TWRP
Letter Database
Communicator
300
What components must match MARX and CI for reinstatement transactions?
Demographics, Plan information, 4RX, Segment #
400
When 2 applications are recevied for the same effective date what 3 things do we use to validate which application to use?
Agent sign date
Stamp date
Scan date
400
What are the 4 ways that and application can be received?
Paper application
Humana Senior portal (SRP)
CMS Online Enrollment Center (OEC)
Electronic Data Interchange (EDI)
400
What are the 6 transaction components?
Denographics
Entitlement
LIS
Plan Information
4Rx
Segment ID
400
What information is needed from the TRR template to complete the letter dase submission?
The Letter tracking id
400
Name the 6 transaction components?
Demographics, Entitlement, LIS, Plan information, 4RX, segment ID
500
What is the election period hierarchy?
ICEP/IEP-D
SEP
AEP/MADP
OEPI
500
What are the ways to view each type application listed?
Paper application
Humana Senior portal (SRP)
CMS Online Enrollment Center (OEC)
Electronic Data Interchange (EDI)
Spidar
Fast Apps
Advance Search
Can not be viewed
500
What are the 7 types of transactions?
Enrollment
Disenrollment
Cancellation of Enrollment
Cancellation of Disenrollment
4Rx
Employer Group Health Plan
Part D Opt out
500
When sending a letter via communicator what is the telephone number used for a MA/MAPD plan
1-800-457-4708
500
What is the screen that comes up after you hit enter on PATR