Medicare Advantage
Where would you direct a Medicare member who wants to set up premium payments online?
What is the web address you would provide a KPIF member to make their premium payment?
If a current KPIF member has questions about coverage for a drug, How would you assist ?
Direct to OptumRX or the OptumRx Portal
Where can we find how much a members copayment is ?
Members Plan Benefits
When is the Medicare Annual Election Period (AEP) ?
10/15-12/7
Can a KPIF member make a payment online without the BUID ?
No
If a caller ask us to fax a copy of an approved authorization to their provider, which flow will you use to request this ?
Material/Literature flow
What flow would we document if a member is trying to get a quote for a mammogram?
Benefit flow
When can we write down a members card number?
Never
What add on plan does a member have to have to have hearing aids, acupuncture/chiropractic and 20 NON emergent transportation coverage?
Advantage plus 2
A subscriber on an HBE plan is calling to update their address, how would you assist?
Direct to HBE and do not update the address
A current member calls and ask about mental health benefits for their spouse, who is also on the plan. The member and caller have been fully verified but there is no DPOA on file. Can you provide this information?
Yes
Can we quote a member for outpatient hospital copays?
yes
How would you assist members whose account in EPIC show bad debt ?
Warm transfer to the appropriate collection agency
What is the name of the Medicare enrollment/election period between January 1st and March 31st?
MA OEP
If a caller is checking the status of their enrollment on a KPIF plan, but they're not in eWatson, where will you check for enrollment?
MQV-Membership Quick View
Where in EWatson will it tell you why a member has a patient responsibility?
On the members claim
If a member is disputing a charge in EPIC stating the service were preventive, how will you assist?
Send a Patient Account flow in EWatson and request a chart review
If a member received a bill from Peace Health St. Joseph Medical Center in Bellingham, WA, will this information be viewable in EPIC ?
NO
What forms of payments (cards) are accepted in IPayment ?
Visa, Discover, American Express, Mastercard
What is the name of gym membership that is offered to Medicare members?
OnePass
Where would we document calls regarding accounts in EPIC?
Patients Accounts