Enrollment
GPS
Benefits
Systems
Claims
100

The enrollment period that starts on January 1st and ends on March 31st.

What is Open Enrollment Period?

100

This is where you can access a ton of information and begin a bunch of workflows.  

What is Menu Navigation?

100

This is the document you use to quote benefits from.

What is the evidence of coverage?

100

This system is the main system that is used by CSRs.

What is GPS?

100

This stands for place of service.

What is POS?

200

The request to leave a plan before its effective date.

What is a cancellation?

200

You need these to close a case.

What is case comments and service requests?

200

This is how a bone density scan is quoted in the Evidence of Coverage.

What is bone mass measurement?

200

This system is used to view grievances and appeals.

What is MedHok?

200

This is the date that the member has the services rendered.

What is the date of service?

300

The member can only be uncovered for Part D for 63 days before this happens.

What is the late enrollment penalty?

300

This is where you find all things Medicare.

What is 'Medicare Attributes'?

300

You use this to quote non-emergent transportation benefits. 

What are one- way trips?

300

This system is used mainly for claims.

What is HRP?

300

This code describes the service or equipment that the member receives.

What is the procedure code or CPT code?

400

This is an disenrollment that the member did not request.

What is an involuntary disenrollment?

400

Clicking this will bring up the "Membership" screen.

What is the 'Policy Name' hyperlink?

400

You should quote this when providing specialty benefits.

What is the referral requirement?

400

This system houses links and helpful resources.

What is the Wiki Tool?

400

This claim tab in HRP will display the message codes which includes important information such as denial reasons.

What is the 'Lines' tab?

500
The is more than one scenario that would qualify a member for this period.

What is the special election period?

500

This service request will start the grievance workflow.

What is Complaint/Appeal/Authorization?

500

This is how a MRI is listed in the 'Benefits section of GPS.

What is 'Diagnostic Radiology- Other than CT'?
500

This system houses authorizations and case management information.

What is MedCompass?

500

This claim tab in HRP will display who has worked on the claim.

What is the 'Audit Log' tab?