CAMS
Where can you locate CAMs
What is under the star in ISET ?
What are the 3 categories of information in regards to privacy with HIPAA?
What is GENERAL, MEDICAL , and SENSITIVE
How can you acesss ETS from ISET?
What is the the big Red A or from the star in ISET
Where would you go to complete a compassion card?
what is the star in Iset ?
Some members have a HSA, HRA or a FSA. Which one do we NOT handle?
HSA
What does HIPAA stand for ?
What is HEALTH INSURANCE PORTABILITY & ACCOUNTABILTY ACT
What is the fax number for an appeal that does not meet the urgent criteria?
What is 801-938-2100.
If ava is down, where can you also find benefit information?
What is IBAAG
What does COBRA stand for?
What is Consolidated Omnibus Budget Reconciliation Act
What does Coordinated payment mean when the associated box in cams is clicked?
That the plan is set to automatically use available funds in their consumer-driven account to pay for and member responsibility amount applied to their medical claims
What is the time frame for an appeal to be reviewed and an outcome to be processde?
between 30-45 buisness days.
Where would you find programs/referrals available for the member ?
What is the dashboard
What program can we provide the member for help with weight loss?
Real Apeal
What header in cams has a double menu ?
what is membership
Can a spouse on the policy request a PlOC/COC letter for entire family?
What is only the subscriber may request a family POLC or COC.
If The member insists on speaking with the appeals coordinator who has signed an adverse determination letter and they do not have a Texas HMO and you can not de-escalate, what do you do?
What is Transfer to NPSR
Where would you go to update COB for members if there is a lock in Other Insurance in ISET?
What is CDB
What is a formulary?
What is a list of generic and brand named prescribed medications covered by the health plan
To search a member for a member in cams using their member ID, what field would use and what do you need to add to it?
What is UNET Alternate ID, and add 00 before
Name 3 of the 7 Seven Individual Rights of HIPAA.
What are Restrictions, Confidential Communications,
Access to Records, Amendment Request,
Accounting of Disclosure,
Copy of Privacy Notice, and
Complaints
How long does a member have to file an appeal for a claim?
What is 180 days from the date the claim was processed
In what system/website you can find vaccine info, INN DME info, and so much more
What is the National Ancillary
When sending a Michigan Coverage Letter digitally, how is it sent?
What is Secure Messaging