Medicare
The country's health insurance program for people 65 or older.
What is Medicare?
This plan's name and plan abbreviation are the same.
What is NHC?
The amount that must be paid out of pocket by the plan holder.
What is the deductible?
This system is considered our Legacy system.
What is EZ CAP?
Where you would go on the plan website to find the star rating.
This will always have a premium and increase annually.
What is Medicare Part B
This plan can be found in VA, CA, Fl & MI.
What is Align Senior Care
Also known as a prior authorization is any decision made by a health plan regarding authorization or payment.
What is Org Determination
Where a provider can check claim status, eligibility and benefits and authorization status
What is the Provider Portal?
You can find the WOL here on the plan website.
What is Plan documents?
The alternative to original Medicare.
What is Medicare Part C?
These are Curana Health's different plan types.
What is ISNP, DSNP & CSNP?
"U down with OPP" but in reverse.
What is PPO?
This system houses various member, provider and UM documents.
What is DMS?
This is what you would do to access the drug formulary.
What is click the search button and type in Formulary?
What is Medigap Part F?
This plan's abbreviation can be a term used to describe a digital device that's designed for individual use.
What is PC - ProCare?
This outlines the benefits and coverage of a health plan and also has the same Initials as this 1981 movie starring Julie Andrews and Richard Mulligan.
What is SOB - Summary of Benefits?
A site used to pull Provider RA's.
What is the Reporting Site?
This is how you would pull up benefits on the plan website.
What is go to plan website, select for members and then my plan documents?
Medicare's enrollment periods.
What is IEP, AEP & SEP?
This plan's abbreviation are the same as this R&B's Singer who sung the smash hit Love.
What is KC - KeyCare
Payment of a fee or grant to a doctor, school or other person providing services to a group of people.
What is Capitation?
A comprehensive healthcare system designed by TriZetto.
What is QNXT & MY QNXT?
What is Contact Us?