Notes

CITRIX TRAINING:
c930549
Join@618

c944735
Vem@1989

C915891
Myname@1234

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

87980
KB8213ky

tcsr22
rules
r07441144nt

ABS:
ky3
trainer1

r07273008
r07441144 bin zhou


ABS Integrity 97803k
==========================

-ABS: (BLUE ZONE)
cngiang ppg and pcp
FOR VIEWING FOR PREMIEM AND PAYMENT HX AND

enter: mminq

pulling up a member : mminq
r07441144
- (healthnet daefult
?
mm1
FS1Lhp

BVD
07441144
97803k

MR: 13K
rice: 1K -
per hour - 71

GROUP:

=====> ABS TRAINING:

ABBREVIATION:
EIP - Enrollment In Process
07711

kb: 55514
type MMINQ - member inquiry
type PV - to know the pcp
type HP - CHECKING PREMIUM -
MMNQ - type LEDINQ - ledger = TO KNOW GROUP
CHksea - = check batch search // payment waiting to be applied
PRVSRC - Provider Search
laterst payment - ledinq > group id -> sub r number > neter alll bell period

HP - premiums
PV - PCP/PPG
AD - address/phone#
SU - subscriber details
NT - notes
Px- pre- existing
BR - bro
CLPRVIN

72-1561134
00787677 mf357a-
a
93039173
860928185

====>>>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

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

[email protected]
[email protected]



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.)

RO7483155



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


00787677 mf357a
R02192976

572488


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



mo: abs - primumm - aptc