Intent
Info101
Glossary
M&R
EASY
100

Intent in quoting pharmacy benefits

Review RX benefits

100

A drug sold without a prescription from a health professional

Over the counter

100

The document that describes any changes to the Member benefits, coverage, costs, premiums and/or service area that will be effective in the new plan contract year.

Annual Notice of Change (ANOC)

100

A federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge. 

HIPAA

100

A document that provides information about deductibles, copayments and kinds of services or products that the plan covers. 

EOC

200

Intent in quoting medical benefits

Review Medical Benefits

200

Coverage Gap is also known as _______

Donut Hole

200

Medications that are not covered by insurance

Excluded drugs

200

Name of the list of items covered under member's OTC

catalog

200

It is the degree to which an employee's actual activities align with their scheduled tasks. 

adherence

300

Intent in looking for a specialist

Search and Assign Provider

300

A copy of a brand name, usually costs less

generic drug

300

amount to be paid before an insurance starts to pay

deductible

300

Department for placing of OTC orders

Healthy Benefits Plus

300

iBAAG is used for what claim system?

COSMOS

400

Intent in checking medications if covered by insurance

Formulary Lookup

400

A term for the way plans share health care costs with the member

Cost share

400

Fixed amount to pay for medical services

Copay

400

True or False: A new email address cannot be added without the member’s verbal consent.

True (Ref KM1007997)

400

Intent used if member is requesting a comprehensive formulary list

Member materials

500

Intent in adding a rider

Managing a rider

500

A meal benefit offered to a member following an inpatient stay

Mom's meal

500

Period after a member met the TROOP

Catastrophic

500

Vendor that administers U-Card

Solutran

500

Medicare part that focuses on outpatient coverage

Part B