What is the system MRM/Custom Point used for?

Tor order EOCs, provider directories, formularies, OTC catalogs, etc.

What is the timeframe for a 1st level appeal (Pre-service) to be completed?

30 calendar days from receipt of complete appeal information

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2023 MAPD New Hire Final Review

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Questions 10

Answers

1
What is the CMS system, used for enrollment/disenrollment transactions associated with the Medicare Advantage program?
Compass
MARx
Facets
Medisys
2
For the plan year 2023, members will pay 25% for Brand-name and 25% for Generic Medications.
True
False
3
This system stores an individual's invoked (HIPAA) privacy rights.
CIRS
Macess
GBD Facets
Compass
4
Name the system that houses copies of paper bills/invoices sent to members as well as checks and money orders received.
Compass
Transcentra
DocHub
Macess
5
Who is the vendor for the Personal Emergency Response System (PERS)?
Best Buy Health
Anthem
CVS/Walgreens
Elevance Health
6
What is the system MRM/Custom Point used for?
Tor order EOCs, provider directories, formularies, OTC catalogs, etc.
I have no earthly idea but I'm sure I will in the near future.
To view copies of paper bills sent to members and check/money order images
To view member premium amounts and enrollment documents.
7
What is the timeframe for a 1st level appeal (Pre-service) to be completed?
7-10 calendar days from the receipt of complete appeal information
60 calendar days from the receipt of complete appeal information
30 calendar days from receipt of complete appeal information
45 calendar days from receipt of complete appeal information
8
Handwritten claims have a high rejection rate and delay processing due to legibility of handwritten information.
False
True
9
What is your line of business (LOB)?
MAPD
DUALS
Medicaid
GRS
10
This is the call tracking system used by MA/MAPD
Knowledge Management
OnDemand
Facets
Compass

2023 MAPD New Hire Final Review Flashcards | StudBud