Life of A Claim
Complaints, Fraud & Privacy
Documentation
Policies
Welcome to the Team
100
Claims are initiated via this telephonic interview/assessment.
What is the Intake?
100
Any written expression of grievance against the Company, any present or former agent, agency, office, registered representative, employee or broker in connection with the solicitation, sale, or service of any product or security.  
What is a complaint?
100
This is the exam used to determine Cognitive Impairment.
What is an MMSE?
100
Definitions,Your Benefits, Exceptions, Claims, Premiums and Reinstatement, and General Provisions.
What are the 6 Parts of the Policy?
100
Sarah Palmer.
Who is the Director of Training for LTC?
200
These are the 3 main types of vendors used to assist in gathering documentation.
What are Clinical, Documentation and Discount Provider?
200
Current Providers,Former Providers, Policyholder, Family Members, Friends & Document Review.
What are some of the sources for reporting fraud?
200
UB04.
What is a Medicare Bill?
200
This was the 1st LTC policy John Hancock sold.
What is the Pilot 87 policy?
200
He is the newest addition to the Training Team, w/over 30 years of experience with the Company.
Who is Charlie Griffin?
300
The On-Going Management of the Claim.
What is everyone's responsibility?
300
When someone’s personally identifiable information has an unauthorized acquisition, unauthorized use or disclosure, or an unauthorized release of other confidential proprietary information.
What is a privacy incident?
300
Facility Form Home Care Provider Form Adult Day Care Form License
What are examples of Provider Documentation?
300
Its primary function is to assist with ADLs and can be provided by skilled or unskilled persons.
What is Custodial Care?
300
Art & Boston sports.
What are Jason's hobbies?
400
Service Center, Technical Unit and Business Integrity Unit.
What are the Support Services?
400
The Business Integrity Unit.
What unit should you report suspected fraudulent activity to?
400
This authorizes JH to disclose health information to designated individuals.
What is a HIPAA Compliant Authorization?
400
This policy pays 80% of the total charges incurred for HHC or ALF up to HHC daily benefit.
What is the Classic policy?
400
Jason's daughter.
Who is Rachel?
500
The SCRs main responsibilities.
What are Educating, Updating and Communicating?
500
Dan Nestle
Who is the LTC Benefits Center Complaint Contact?
500
In the absence of legal capacity, this individual handles the insured’s financial affairs.
Who is the General Durable Power of Attorney?
500
This was the 1st policy to exclude care provided by someone related to you by blood or marriage.
What is the '90 policy?
500
The class troublemaker.
Who is Nancy?