Show:
A&G
VCCD
HIPAA
Medicare
MIIM
100
Appeals and Grievances
What does A&G stand for?
100
Ready
What is the icon you use to show you are available?
100
Member Name, Member ID, Member DOB, Member Medicare ID, and/or Member complete address
What information is needed to HIPAA verify the call?
100
Age 65 and older, under 65 with disability, has ESRD
What is the requirements for Medicare?
100
MIIM
What is Member Interactive and Issue Management?
200
Any dissatisfaction the member shows against the plan.
What is a Grievance?
200
After Call Work
What is ACW?
200
After Call Purpose
When do you HIPAA verify the call?
200
Part A and Part B
What is original Medicare?
200
Recent Interaction Tabs
Where can you see prior notes left by agents?
300
Appeals, Grievance, and determination
What are the three points of A&G?
300
Redirect
What icon would you use to transfer or conference a call?
300
Basic Plan Information Member Enrollment Information Member Claims Information Member Medical Information
What information can be discussed when call is Authorized Representative?
300
Medigap
What is another name Supplement Medicare?
300
Wildcard %
What symbol would you use when searching a member by last name?
400
Member is upset about an area of the plan.
What is a Grievance?
400
Release
What icon do you use to complete the call with the member?
400
HIPAA
What is Health Insurance Portability and Accountability Act?
400
have BOTH Medicare Part A and B. •live in the service area in which they are enrolled. •continue to pay their Part B premium. •not have ESRD.
What are the requirements for Medicare Advantage?
400
General, Plan, Member, Billing, Claims, Application, Enrollment, Pharmacy
What are the categories in MIIM?
500
Complaint to Medicare
What could cost the company thousands of dollars for lack of documentation?
500
Retrieve
What icon would you use to go back to your member?
500
Address, phone number, email address, plan changes, and PCP changes
What information can the POA update?
500
HMO, PPO, PFFS
What are the different types of Medicare Advantage plans?
500
Member/send non-marketing material
What category and intent will you use to send material to the member?