Final Review-UHC Questions and Answers with Complete Solutions UPDATED!!!!.

https://www.stuvia.com/user/Performance


Final Review-UHC Questions and Answers with Complete
Solutions UPDATED!!!!




PDP Plan - ANSWER Prescription Drug Plan (Medicare Part D)



PDP benefits - ANSWER -Help members save on the cost of
drugs

-Help members manage their healthcare cost

-Provide coverage in case health care needs change in the
future



PDP Systems - ANSWER -Maestro

-GPS

-MARx

-RxClaim

-RxWeb

,https://www.stuvia.com/user/Performance


When to use PDP standalone plans job aids - ANSWER -
Determine premiums and copays for a particular state

-Calculate the cost of a less than one month supply

-Answer member questions about PDP standalone plans



GPS - ANSWER The Next Generation Policy System, it is a web
based application used across Medicare and Retirement to
maintain customer information



Household summary of GPS - ANSWER -Household summary
panel

-Profile summary panel

-Active Conditions panels

-Auxiliary person summary panel

-Billing summary panel

-Contact history summary panel

-Fulfillment request panel

, https://www.stuvia.com/user/Performance


-Pending payments and refunds panel



Letter writing - ANSWER -Use GPS to send manually generated
letters (MGL's) to members

-View letters using CCP in GPS until they are archived. After
that, letters are only available in EDMS



Verbal Grievance - ANSWER -An expression of dissatisfaction
other than coverage determination or organization
determination

-About any aspect of the health plan's operation, activities, or
behavior.

-Regardless of whether remedial action is requested



Types of Quality of Care Griveinces - ANSWER -Care provided by
the medical provider, facility, hospital, or pharmacy was
inadequate.