COLUMN 1
What are two things needed to close a case?
Case comment & SR
What is the abbreviation LIS?
Low Income Subsidy
What do we verify before requesting an ID card?
The member's mailing address
Where in GPS can you find the case number?
Case Info
Where do we go to see the member's uncovered months for LEP?
View Medicare Attributes
What is the benefit for a flu shot?
There are no coinsurance, copayment or deductible for the flu/influenza shot
What tab do you select to put a subject on a case?
Clicking the members name/Details
Who would be the alternative option for the member to get transportation services?
Resources for Living (RFL)
What are the OSB members are able to add to their plan?
Dental, Vision & Hearing
What is the benefit for a mammogram?
There is no coinsurance, copayment or deductible for covered screening mammograms
What is the allowance amount for the member to get a wig?
$400 benefit allowance amount
What is the benefit for Urgent Care?
$25 copay for each Medicare covered urgent care facility visit
What is the abbreviation DME?
Durable Medical Equipment
How do we check to see if a provider is in or out of the network?
Find Care
What is the benefit for ER?
$125 copay for emergency care
True or False: A urologist is not a specialist
False
What is the abbreviation MOOP?
Maximum Out of Pocket
Are there any referrals on file for the member?
There are no referrals
Who covers for hospice care?
Original Medicare
What provider have we teamed up with to provide eyeglasses for the member?
EyeMed
Does the member have a POA on file?
There are no POA/Authorized callers on file
What is the benefit for a prolia shot?
20% coinsurance for all drugs covered under Medicare part B
What is one of the tool used to check for prior authorizations?
MedCompass
Where can we find the MOOP in GPS?
Accumulators
What benefit is a wheelchair considered as?
Durable Medical Equipment (DME)