GROUP
How many is 101+?
This should be added within subscriber/family anytime a subscriber record is updated.
What is a Note?
You are enrolling a 31 MD newborn without no name provided, you will enter this in Facets for the First and Last Name?
What is:
First Name- Baby boy or Baby Girl
Last Name- Mother's Last Name
The three reasons an ID card may need to be triggered.
What is:
PCP Change
Plan Change
Subscriber Name Change
The Primary Care Dentist (PCD) information needs to be added to this section and tab in facets for Members enrolled on a Dental HMO.
What is Members and Attachments Tab?
To locate the plans offered for each class you will go to this section in the group application.
What is class/plan?
The Policy Original effective date is found in this section of facets.
What is Subscriber?
If a language preference is not provided on the enrollment request this code is selected in facets.
What is NS01?
This Facets application is used to locate provider information such as age limitations, if they are accepting new patients, and their contract with BSC.
What is Practitioner?
The member requests an address update, but the address provided is out-of-state; You will do this.
What is Do Not Update and confirm with group?
You will navigate to this section in the group application to determine the open enrollment period for a certain class and plan
Where is Group> Class/Plan> Select Plan (PPOX0001) > Open Enrollment Period?
The type of eligibility event that should be added when cancelling a dependent or 31 MD
What is Separation?
What tool is used to determine the Effective date for a standard enrollment?
What is the Effective Date Calculator?
This tool is used to calculate the Cobra End Date.
What is the Effective Date Calculator?
When reinstating a member with a lapse, this is the reason code you will select.
What is E022-Sub Reinstate W/Lapse?
You use tool this in facets to determine the groups retro add/term rule?
What is the EBR Table?
The section and tab within the facets sub/fam application to locate a members assigned primary care physician
What is Members and PCP?
A newborn without a Selected PCP on a HMO plan will be assigned what medical group?
What is Enrolled in the Same IPA (Medical Group) as Mother (if mom isn't on the plan, Subscriber)?
The Cobra class in Facets will start with this
What is C1XX?
When an employer requests to cancel a subscriber as never effective, you will use complete what steps in Facets Eligibility section?
Void the select event
(Highlight the eligibility row you want to void>Edit>Void)
You will transfer from the class/plan section in the Facets Group Application to this application to locate the VIP code.
What is Subgroup?
This section in facets is used to verify ALL member eligibility and benefits assigned.
What is Eligibility Inquiry?
Gender Identity Data for a new enrollment is added in this area of Facets.
What is Enrollment Application>Indicative>Demographics Data Button
You must add these two events in the eligibility section when enrolling a Cobra Member.
What is Cobra Begin Date and Cobra End Date?
The Maximum amount of time a subscriber/dependent can be enrolled in Cobra Benefits.
How much is 36 Months?