Outlook correct answers used to send and receive emails
CNET correct answers Centene's intranet, house important company news and links
KB correct answers Centralized location for informational documents
Customer call center reps assist members and providers with their customer service con...
Centene (100% Verified Solutions)
Outlook correct answers used to send and receive emails
CNET correct answers Centene's intranet, house important company news and links
KB correct answers Centralized location for informational documents
Customer call center reps assist members and providers with their customer service concerns correct answers true
The Performance Group Unit (PGU) is a specialized unit that handles calls from brokers, employer groups, third party administrators, and internal sales correct answers False - Account Service Unit (ASU) unit that handles calls from brokers, employer groups, third party administrators, and internal sales
Will you answer and assist Medicare Advantage Member telephone calls correct answers False - Medicare Advantage member calls are handled by Medicare Advantage member services
which agency regulates California HMO plans ? correct answers DMHC
PPG correct answers A group of Physicians organized to provide medical care to Health Net Members
Tier 1 correct answers Health Maintenance Organization HMO
Tier 2 correct answers Preferred Provider Organization PPO
Tier 3 correct answers Out of Network (OON)
PCP correct answers Primary Care Physician responsible for directing member's care when on an
HMO
On the CA HMO plan, what is the negotiated dollar amount paid to the medical group/provider per member, per month (PMPM) to cover the cost of covered health care services is called ? correct answers Capitation
When a CA member travels to another state, their HMO plan will cover what type of services? correct answers Emergency/Urgent Care
The PPO plan has 2 tiers available, what are they? correct answers PPO and OON
On a CA EPO plan, Health Net will act as the medical group correct answers True
Point of Service/Select plans have three tiers: HMO, PPO, and OON correct answers true- POS plans have all three tiers of coverage
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