Tier2

Off-Exchange member on 3/4/2019 wants to cancel, what is the PTD

• 03/01/2019

• 03/04/2019

• 03/31/2019

• 04/01/2019

How do you handle the inquiry to resolve cancellation for the member?

• Send to an Operations Expert to cancel the plan

• Send to Enrollment & Billing (E&B) to cancel the plan

• Transfer to a Health Plan Advisor (HPA) to try to retain the member

• Cancel the plan for the member

Off-Exchange member wants his plan reinstated after his grievance is approved. You collect an un-validated payment, What is the next step?

• Reinstate the member is ISG

• Send a service request through Solution Central to E&B to reinstate the member

• Transfer the member to a Health Plan Advisor to be reinstated

While researching in ISG, you find that a member has unprocessed cash. How do you handle unprocessed cash?

• Apply the unprocessed cash in ISG

• Send a request to E&B using ISG

• Apply the unprocessed cash in Solution Central

• Send a request to E&B using Solution Central

A Certificate of Authority is a form indication that the signer is ___________.

• The executor of the member's will

• The spouse of the deceased

• Any person named in the wil

How many days within the birth of a child must a member notify Anthem to have the baby added to the plan with no interruption in coverage?

• 31 days

• 31 + 5 days

• 60 days

• 61 days

What would be the effective date of coverage for a baby, born February 2nd?

• 02/01/2019

• 02/02/2019

• 03/01/2019

• 03/11/2019

What step would you take to add a newborn?

• Transfer the call to the state's exchange.

• Transfer the call to a Health Plan Advisor (HPA)

• Create a service request in Solution Central.

• W

Which states have MORE THAN 31 DAYS to add a newborn to a legacy policy?

• Colorado, Georgia and Nevada

• Connecticut, New York and Wisconsin

• Indiana and Ohio

• Illinois and Missouri

Using the Lookup Code function in Solution Central what type of visit is 99283

• Urgent Care

• Preventive Care

• Office Visit

• Emergency Room Visit