Eligibility
The relationship type of an employee who owns the policy.
What is Subscriber?
From January 1 to December 31.
What is Calendar Year?
The main tool that we use to check the members' information, eligibility, coverage, benefits, providers, claims and etc.
What is ISET?
Family Practice, General Practice, Internal Medicine, Pediatrician and OB-GYN
What is Primary Care Physician?
The business unit that we are included and supporting.
What is Employer and Individual?
An individual who relies on an enrollee for financial support and/or obtains health coverage through a spouse, parent or grandparent who is the enrollee.
What is Dependent?
Amount that needs to be satisfied before co-insurance kicks in.
What is Deductible?
The source of truth.
What is Knowledge Central?
Default mileage set in searching for the nearest provider/s within the area of thee member's zip code.
What is 25 miles?
Honor commitments. Never compromise ethics.
What is Integrity?
A managed care plan that has both INN and OON benefits with a product code PS1
What is Choice Plus?
Pharmacy benefit manager of UnitedHealthcare
What is OptumRx?
An innovation tool used to route a request to other department correctly and efficiently.
What is KA Automation Tools?
Physicians that are rated best in quality and cost efficiency.
What is UnitedHealth Premium Designation/UHPD?
The headquarters of UnitedHealth Group.
What is Minnetonka, Minnesota?
The account/employer groups that assume only the financial risk for the payment of monthly employee premiums, and where the carrier assumes full risk for actual medical expenses incurred. A type of funding arrangement that is subject to all state and federal regulations.
What is Fully Insured?
Equipment and supplies for medical conditions ordered or provided by a physician for outpatient use. Not consumable or disposable and not of use to a person in the absence of a disease or disability. Appropriate for use in the home
What is Durable Medical Equipment/DME?
Used to check all the information about the member's FSA or HRA account.
What is CAMS?
A set of numbers used by a provider to identify his/her status with UHC.
What is Tax Identification Number/TIN?
A line of business of UHC that handles employer group with more than 100 employees.
What is Key Accounts?
Federal law that requires employers with 20 or more employees to offer continued group health coverage to employees and the employee’s dependents for a time after they leave the group health plan under certain conditions. This is called continuation of coverage.
What is COBRA?
Annual pap smear, Breast examination, Laboratory and diagnostic services in connection with evaluating the pap smear, Mammograms for the screening of breast cancer and Routine gynecological examination
What is Well-Women?
A specialist for Ears, Nose and Throat.
What is Otolaryngologist?
Current rank of UnitedHealth Group in The Fortune Top 10 Companies.
What is 6th?