Notes

TRAINING OMNI:
http://pg-stgapp4:8014/prweb/PRServlet

======> CITREX ACCESS

C901727
Ikkitousen!3

C971546
Jos$1234

C0913283
Jimboi#23

C915891 (CHO
Myname@1234

C930549
Join@618

C944735
Vem@1989

C995660
@1n@n0ya

=====================>
87980
KB8213ky

C942521
Asdf$123

55514 abc codes ***
37950 reinstatement policy

tcsr22
rules

===========> R NUMBERS ==============

r07441144nt
r07273008
r07441144 bin zhou
r0742950
00787677 mf357a
R02192976
RO7483155

ABS:
ky3
trainer1

ABS Integrity 97803k


==============> KEYS:
89709 oMNI bILLING INQUIRy
5514 abc codes
37950 reinstatement policy
82314 aca solutions
38212 az group
80275 tape group
300471 eligibility
15295 cobra
87980 reinstatement
81558 demographic changes
8404 arizona3812 az eeg
48099
11084 COBRA
54344

================> REPORT
OMNI BILLING INQUIRY
FISERV PAYMENTS
kb: 89709

ibilling
stndard billing
automatic back draft

ERROR CODES:
AMINV
ANIMAX
ammin
oavel
pablk

*Agent Web
*Infor Portla
*Consumer/member Web
Billmatrix
Velocity
Wallet
Block payment Account

payment Options:
online
IVR
store
mail

========87980
REINSTTEMENT POLICY FOR NON APTC
MEMBERS DEMOGRAPHIC INFO
Reinstate - c8 - cancell deu to non payment > abs

=== 55514 ABS COMMANDS



====>>>REINSTATEMENT POLICY FOR NON APTC IEX MEMBERS

* Can only reinstate if reson code for cancellation is C8
C8 - ABS>NMINQ>S4>CXRSN=C8 non payment dues
* once the account is reinstated , effective date is the cancellation date
& only applicable once in every 12 months* memeber must not be an APTC recepeint. APTC - if yes _> refer to the exchange

* member has only 30 days to reinstate the account from cancellation date ( if non aptc)
*past due is not more than 1 month
*Premum payment +past due +5$ RF on the date of reinstatement
*Associates request for pre instatement (Macess)
* memner will receive resintatment letter if eleigible


r06845949 KAREn dycann

c8 reinstate
c7 go back to marketpalce

- iex non aptc mem will call HN within 30 dys from cancellation

* will not reinstate if a mem received premium susbsitdy (aptc) go back to exchange

aptc
type:

*
1,confirm the member if is nont i active status

2. confirm on on OMNI and ABC
3. take payment for past due for 5$
4. provide effectivity date for reinstatemnt
5. route a service form /service object to membership via "

ACA CONTACT CENTER ISSUES GUIDE AND SOLUTION TEMPLATE:
- demographic
- termination request
regfund request
corection update
abd renewal
reinstatemtn request for non aptc memebr
billing issues
delinquency - aca solution - create a case

============>

UPDATING DEMOGRAPHIC KB 81558
a.) Name spelling correction
b) Phone # change
c) Physical Address Change
d) date of birth
e. gender
f. Preference


email:
[email protected]
[email protected]

Criteria for Judging:
Rules:
PROGRAM:
1. Group cheer dance
2.
GAMES:
BEST TEAM selfie afard
Intergrity - Mind games

Professionalism: Merry go round
Respect: Dragon tail
Innovation: Paint me a Picture
Commitment: team volleyball

find : update phone number


================FISERV
Agent Web -System the CSR will use to process member payments
InfoPortal -Fiserv system: CSR’s will log into to review payments and to locate the make a payment on the Agent Web screen
Consumer/ Member Web The online payment system a member will use to make a payment
Wallet A “folder” that allows the member to create, update, and cancel their saved payment methods
Billmatrix The name of the payment system a member will use when making an Online, IVR or Walk-In payment
Velocity The term used to identify how many payments a member can make through a specific time frame
Blocked Payment Account A member’s account can be blocked for future payments if they had a returned check for Insufficient funds, or if a card was reported, lost or stolen etc.)

TAPE group -
employees that provide health net information via computer file.

Mmeber request demo update= If OMNI allow, we can but temporary
THEY NEED TO GO BACK TO EMPLOYER FOR VERIFCATION
OMNI will not provide that member has a grp
In4m member to go back to employer


ENROLMENT EXEMPTION
YES NO Members is under Tape GRP

YES YES we can change and no need for the member to go back to Employer

Not found Not found business as usual

HN CONNECT
LOTUS
KB
CITRIX
OMNI
ABS


3 status

ACTIVE
CANCELLED
EIP


eli

before trnsfer = check C // check 5 0 7 business days = chksea

Eligibility Requirements

1. Member’s Name
2. Status
3. Member’s Effective Date
4. PPG Name – (HMO only), or the type of Product – (PPO only)
5. PCP Name – HMO product only


ACTIVE good standing & eligible for HN coverage
CANCELLED not with HN or not eligible
EIP (Enrollment in Process
no services are covered until BP is settled
BP makes binder account active
Destiny Flores
active
HMO Tier MAHOUBI R RAY
PPG:AZ DIRECT NETWORK - MARICOPA
HNAZ Large Group Federal Employees HMO


“As of today, our records indicate that (Member Name) is Active on ELECT OA 2-TIER including HMO and PPO tiers effective 10/01/2012. Under the HMO tier, the Member is assigned to (PCP Name) with (PPG Name) effective 10/01/2009 . Under the PPO tier, the Member must seek services from a Health Net PPO contracted provider.”

COBRA Consolidated Omnibus Budget Reconciliation Act


MEDICARE members has 2 plans


TERMINATION AND CANCELLATION OF COBRA:
1 SUBSCRIDER id
cobra direct pay - they can cancel the cobra policy over the phone


ADDITIONAL ELIGIBILITY INFORAMTIONl: OPTION HEALTHNET 85975
1.Hospital infomration
2. general plan information
3. other health insurance
4. additional plan information

DIFFERENT FIELD OF SEARCH IN OMNI
r number
first last name
date of birth
ssn
alternate ID

WHAT IS HIPPA VERIFICAITON
first last
address
date of birth
phone number on file

WHERE DID YOU LEAVE NOTES THE ACOCUNT
insde the internt
tools- > add note

HWERE YOU SUBMIT A UPDATE A BIRTHDAY
from option reason for change:
1. date entry error
enrollment submission error
other

WHEN YOU UPDATE A MEMBERS ADDRESS
THE CONFIRMATION page
your request has been submitted please allow 3 business day s for processing to be completed

what is