Notes

PRODUCT TRAINING
DAY 1:
ACA

INTRANET VS INTERNET:
INTERNET - available to everyine provied that they have access to gina network


INTRANET privately maintianed a private computer network that can be
privately secured
only authorized individual hasve access

cids: citrix id -


GREETING - 5 SEC - COMPANY - NAME
- ACCURATE AND COMPLETE -
read the disclaimer + foiotnotes

RESOLUTION

CLOSING:
complete documentation? reason of call // indicate foot notes//
is ther anything else?
clising- thank the Cx and say good bye//


never repeat the
some of the information you porided did not match

CSR - Cost Sharing Reduction / share expense from the Government and Provate institution

TOOLS :
- citrix
- kb
- lutos notes
- abs

username: C944735
pw:Vemc1989


Medicard and Medicare

APTC - Advance Premiere Tax Credit -
subsidy provided by the governemtn


ACA - Affordable Care Ac
The Affordable Care Act puts consumers back in charge of their health care. Under the law, a new “Patient’s Bill of Rights” gives the American people the stability and flexibility they need to make informed choices about their health

HMO -health maintenance organization

health maintenance organization (HMO) is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities in the United States and acts as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis.

PPO - Preferred Provider Organizat
A PPO is a Preferred Provider Organization within the framework of the managed care health insurance industry. A PPO is a group of doctors, hospitals, and other health care providers who create a network and negotiate predetermined fees with a given health insurance carrier

PCP - Prmary CAre Physician
A health insurance term used to describe a physician who is responsible and coordinates all of a patient's care in a managed care system like a preferred provider organization (PPO) or health maintenance organization (HMO). The primary care physician is the primary point of contact with the insured patient and acts as a gatekeeper controlling the insured's access to health care through the insurer.


PPG - Primary Physician Group

IFP - Individual Family Plance

EOC - Emergency operation Center

SBC - summary of Benifits

SOB - schedule of benifits

HNCA - Health Net Life Insurance Company

HNOR - Health net health plan of Oregon

HNL - HEALTH INSURANCE COMPNAY

HIPPAA - health insurance portabilty and accountabily act

SHOP
PHI -
PII
MEMBER
SUBSCRIBE
DEPENDED
KB
DEDUCTIBLE
CO-PAYMENT
CO-INSURANCE
OOPM
PROVIDER
CSR
MAA
CAPITATION
PLAN CONTRACTED RATE
BILLED AMOUNT
DIFFERENCE


IEX - on exchange oruce ti amrket that is provided by the governemnts
IFP - oof exchange
- purchase from private insurance


10 ESSENTIAL NEEDS

- Emergency needs
-Maternity services and Newborn care
- Rehabilitative and Habiliative
-mental Health and Substance abuse
- Prevent ive Wellness and Chronic disease management
- Hospitalization
- Laboratory services
- Predictric services
- ambulatory services
- Prescription drugs