Show:
Group Refund Processing
Invoice QA and Reconciliation
Payment Preference - Group
LIS LEP Reconciliation
100
Who is responsible for creating and mailing the refund checks to the group?
Visiant Finance Operations
100
When does Ika automatically runs and generates the invoice extract to begin the month’s invoicing process?
6th of the month
100
True or False. The bill is then mailed by the visitant finance to the address stored in the system for the group.
Flase
100
____ incurred and calculated by Centers for Medicaid and Medicare Services (CMS) when a member has a gap in drug coverage greater than 63 days.
Late Enrollment Penalty (LEP)
200
After the request is routed back to BPO to inform that a reversal is in order, how long should the outstanding request be before it is escalated to the lead?
2 business days
200
It is the process of calculating the premium amount on the basis of a member’s eligibility and providing this premium determination as output to the client for use in some form of member communication.
Invoice Generation
200
All employer groups receive a monthly invoice via?
Direct Mail
200
Who will assign the group records on the LIS and LEP Reconciliation Report to BPO Processor?
Billing Supervisor
300
When a payment is received for a group division that is greater than the premium amount billed for a corresponding coverage period, the payment will be placed in the group’s account as?
Credit
300
Upon validating the member payment preference option, if it is Direct Bill, what should be the next step?
Check for unapplied payments
300
What are the levels at which invoices are generated for the group?
Group, Division or Member
300
A tool that is used to create LIS and LEP discrepancy reports.
User Controlled Access (UCA)
400
After clicking "Process Payments", ikaBilling will apply the adjustments to the invoice, update the status of the adjustment payments to Complete, and, if applicable, update the invoice status. How much should the Unapplied Batch Balance cost in order to process the payments?
$0.00
400
True or False. At the time of enrollment, a premium cost per month is calculated for a member’s plan based on the plan selected and the member’s permanent address location.
True
400
True or False. The request needs to be routed by a Visiant Finance associate and from Customer Service or the Mailroom.
True
400
A Software that automates all key processes in the Medicare cycle—from product design and marketing to sales and enrollment to proactive care collaboration—and helps businesses adhere to CMS requirements, address new opportunities such as dual-eligibility administration, and maximize CMS Star ratings
IkaSystems
500
When entering a debit adjustment, what details do you need to update to reflect the refund details? (Give at least 3)
Coverage period, Check #, CHK/ACH Date and Amount
500
Upon checking the Unapplied Cash Aging report, if the member is found but the unapplied payment does not match with the Invoice Extract File total amount, what formula will you use to compute for the new amount?
New Total Amount = current invoice extract total amount - total unapplied amount
500
If the request has an image, what do we need to open?
Content manager
500
In the Election List screen, Discrepancy Qs, what should be selected to generate Excel for members that has LIS discrepancies
Demographic Discrepancies, then select LIS in discrepancy dropdown.