The source of truth for eligibility
One Source
Where to find the Agent of Record
Patient Account
Coverage applies to these + 20% coinsurance
Doctor visits
AOR
Agent of Record
Three-way call or in-person introduction
What is a warm transfer
Insurance expert every patient meets at WV
Patient Relations Manager
Tool to check the insurances we accept
Plan Acceptance Tool
The amount paid before Medicare kicks in
Deductible
AEP
Annual Enrollment Period
Offers real-time insurance help at events
Agent
Don't count on getting this filled
Prescriptions
Where I see my pacing
Executive Dashboard
Cost of having Part B
What is the monthly premium?
$170
SEP
Special Enrollment Period
The dual in dual eligible
Medicare and Medicaid
Need for billing and blue button
Medicare ID
PRM said closing but adjusted membership report said no
Flow-Through Case
Dental, Vision, Gym membership, OTC, meals, transportation, etc.
What are Medicare Advantage benefits?
LIS
Low Income Subsidy
Bakery pizza - OK, Supreme pizza - NOT OK
Compliance rules with IAs and food
WV duration and breakdown
1hr and 20 minutes: 20 PRM, 40 MA, 20 PCP
Events that provide prospects insurance help
Campaign with an IA
Bummer - I didn't enroll when I was eligible, now I'm paying this every month
10% per year penalty for Part B & 1% per month for part D
QMB
Qualified Medicare Beneficiary
Moving from Fee For Service to
Managed Care / Medicare Advantage