Medicare 101
Dates
Call Flow
Authentication
Abbreviations/Definitions
100

PPO means

Preferred Provider Organization

100

Sept. 3-30

ANOC and EOC are mailed out

100

What is the first step in the call flow?

Greeting the caller

100

What 2 things authenticate a provider?

NPI/tax ID

100

SNP

Special Needs Plan

200

HMO means

Health Maintenance Organization

200

annual enrollment Period

10/15 - 12/7

200

Show empathy is what step in the call flow?

Step 2

200

What are the 3 main things that authenticate a member?

Member ID 

Zip code 

DOB

200

RRB

Railroad Retirement Board

300

The person receiving the benefits.

Beneficiary

300

Jan 1- dec 31

Policy effective dates

300

How many steps are in the call flow?

eight

300

What button do you press when talking to the member

Interacting with and about

300

Premium

Amount a member pays monthly for insurance coverage

400

What does CMS stand for?

Centers for Medicare & Medicaid Services

400

Jan 1- March 31

Open enrollment period

400

What is the 4th step in the call flow?

Resolve the issue

400

Interacting With

When talking to anyone other than the member.

400

PDP

Prescription Drug Plan

500

# things that qualify you for Medicare?

3 months before or after turning 65

ESRD

Be on disability for 2 years

500

period when Medicare members can enroll in or change their existing Medicare advantage plan

Open enrollment Period

500

What does solving inquiries reliably mean?

Giving precise and accurate information

500

When you get permission over the phone from the member to speak on their behalf

Verbal consent

500

Benefits that replace some of your earnings when you retire

SSA BENEFITS