Payments
WI
Good Cause
Auth
RM Task
100

How Many Different Types Of Payment Method's Do We Accept. 

Mail ,Credit, Debit, E-check, In person. ( Visa, MC, Amex, Discover)

100

What Is the CIF for Silverscript Med D.

Client Code: X9110

100

How many days do you have to request good cause reinstatement after being disenrolled? 

60 Days 

(CMS-PRD1-0638980)

100

What 4 pieces of  Information is needed from a transferring agent

Verbal Consent, Full Name, DOB, Zip Code, 

100

True Or False? can a task be sent to set up payment plans?

True

200

What Days Are Payments Processed With Auto Pay? 

Between the 8th and the 10th 

200

What WI Would You Pull Up for Payment Plans?

CMS-PRD1-101905

200

How Long Does The Member Have To Pay the Previous Premium Balance? 

within 90 days of disenrollment 

200

True or False Can a POA make changes to the account?

True 

200

What Is the TAT for submitting a Dunning/Disenrollment Task? 

10 Business Days

300

Can A Member Set Their Own Payment Date?

True Or False?

False


(CMS-PRD1-073397)

300

What WI would you pull up for a member calling in regards to loss of LIS?

TSRC-PROD-054288

300

If Good Cause is Favorable, how long does it take for the plan to be reinstated?

Within 5 Day

(CMS-PRD1-114370)

300

If member does not know member id, what is a secondary authenticator?

Prescription Name, Prescription Number, MED D Only: MBI

300

What Task Type would you use to dispute a payment? 

Premium Billing Inquiry Medicare D

400

How long does it take for SSA/RRB deductions to start?  

It may take two or more months for deductions to begin.

(CMS-PRD1-073397)

400

What's The WI You Would Use For The Language Line And The Access Code?

CMS-2-004378; Code: 13736

400

How Will The Member Be Informed When A Determination Is Made? 

A Written Notification Will Be Sent In The Mail Within 2-3 weeks

400

True or False  can Auto pay be updated with an unauthorized user?

False

400

What's the first thing we need to verify when submitting an RM task?

Verify there is not a task in progress

500

How Many Days Prior To Enrollment Will You Receive An Invoice?

45 Days From Enrollment Effective Date

500

What's The WI You Would Use For Request From Department Of Housing? 

CMS-2-024871

500

Can A Member Resubmit a Good Cause Reinstatement Request After It's Been Denied?

No, You can only submit one request 

500

What Information May You Not Provide Emergency Medical Personnel?

 Make any decision on HIPAA information to share/release outside of what is allow under Providers.

500

Prior to submitting the RM Task when a beneficiary is disputing their Dunning/Disenrollment. what 3 things must agents confirm

  • Recent payment 
  • If applicable, check number, date mailed, and whether it has cleared beneficiary’s bank account.
  • Confirm if payment was submitted and received before the Dunning Grace Period End Date.