Funding | Medicare | SSC | PEGA | RESOURCES |
---|---|---|---|---|
Mail, fax or online
How can a participant submit a reimbursement request
|
3 months before, the month of and three months after the participants 65th birthday
When does ICEP take place
|
The funding guide tab
Where can you find if an account is joint or separate
|
Pega
This is where you will find guided assistance
|
Vantage
This is where you clock in and out of everyday
|
The file will be queued to be sent to the funding department for processing
What does payment mapped mean
|
Continuous coverage which no breaks and gaps longer than 30 days
What is credible coverage
|
The funding summary tab
Where can you find out if a participant had funds retracted
|
Denied reimbursement request
What case would you choose if a request had sufficient documentation but wasn't approved
|
The client guide
This is where you find client updates
|
An overpayment
If a participant passes away and a/r is still on, what can happen
|
During AEP
When must a participant enroll to ensure a January 1st effective date
|
The funding amounts tab
Where can you find a participants next allocation amount and period
|
Loss of funding
What case would you choose if a participant didn't meet the clients requirements
|
Sharepoint
We go here to access the client guide, carrier guides and resources
|
Incorrectly submitted case
What's an ISC
|
CMS
Who regulates original medicare
|
Signed applications and policies screen
Where can you access the archived applications
|
Missing allocation
What case would you choose if a participant meets the requirements but doesn't have funds loaded
|
Infosource
This group is for ALL issues outside of auto reimbursement
|
A social security award letter or a part b billing statement
What two documents can a participant use to get reimbursed for their medicare part b premiums
|
Medicare
With medicare supplement plans, who pays first, medicare or gap
|
Payment mapped
This is a payment status notification from the carrier that a participant has paid their monthly premium
|
When instructed by the client guide
When do you route to the data team through pega for a death notification
|
A/r helpdesk
This group is specifically for auto reimbursement payment issues
|