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MAPD Week 3
One can find a member's benefit cost-share in:
True or False?
MAPD Week 3
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Answers
1
True or False?
False
True
2
One can find a member's benefit cost-share in:
Compass
EOC
MACESS
iHealth
3
What is an EOB?
Essence of Bravado, a term used to describe Viking stories
Evidence of Benefits, sent to providers to demonstrate truth
End of Business, the daily report sent out by Team Leaders
Explanation of Benefits, sent to member regarding claims
4
What system would you use to see what kind of billing a member subscribes to?
Client Console (ORCC)
eStart
ORCC (Client Console)
Member Checking Account Viewer (MCAV)
5
When a member changes a PCP, what happens?
A welcome packet issues in the mail with details of new PCP
Medical Magic
The change is registered in MACESS
New ID card issues within 10 to 14 business days
6
Where would you go to find a provider for a member?
Ask Jarod
Anthem.com
Farmersonly.com
Provider finder websites available through Compass
7
Why are the Roman wars with Carthage called the "Punic" wars?
Carthage was a Phoenician colony (from the Latin "poenia")
Because they were puny
The word "Punic" refers to the military punishment Carthage
"Punic" is the ancient Roman word for "Police Action"
8
What is EDInet?
A place where rejected claims are stored
A data warehouse that stores rejected claims
A rejected claims data warehouse
A place where some guy named ED keeps his Inet
9
What is the "disallowed amount?"
The opposite of "allowed amount"
The member's financial plans for the future
Write-off
The monetary difference between copay and deductible
10
When accepting a payment in Client Console, (ORCC) what MUST you provide the member?
Routing Number
Confirmation Number
Checking Account Number
Interaction Number
11
MOOP
Maximus Out Of Pocket
Maximum Out Of Pocket
Maxmegalon Order Of Penguins
Minimum Out Of Pocket
12
What is "Member Responsibility?"
The proper usage of one's powers, where abundant.
Deductible + Copay + Coinsurance
An obligation to call to mind one's duties
The "Paid" amount
13
Where would you locate a member's Medicare ID?
At the top of Compass
Member Composite
On their Anthem card image
HIPAA verification page
14
DME stands for
Declining Mid-Eocene
Dispeptic Mediocranial Embolism
Diagnostic Myocardial Eurythmia
Durable Medical Equipment
15
Where do you find an EOB?
MACESS/OnDemand
Compass
I don't knooooowwww! (whimper)
You didn't cover this in class! (whine)
16
How do you find answers to questions that haven't necessarily been covered in class?
MAPD Wave 5 Resources
Medicare Programs Service Center
Knowledge Library
Atlas
17
Where in Compass do you search for a member's cost share for a procedure?
Member Composite
Provider Search Criteria
Benefits/Authorization
Research Item
18
Customer Service may provide correct procedural codes to a provider upon request.
True!
Heck Naw!
False!
Aw Yeah!
19
Where do you find EOCs and ANOCs?
Anthem.com
Atlas
IDK LOL
eShare/ePST
20
DOS stands for...
Digital Operating System
Don't Overthink Stuff
Date of Service
Denial of Service
21
What kind of billing options do members have?
Automatic Billing
Direct Bill (Mail)
Customer Service
SSA/RRB
