Exam (elaborations)
Wellcare Notes 2023/23 with Complete Solutions
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Business Required Document (BRD) - ANSWER-written by business analyst (BA); created when new CMS regs come out, DTRR comes to us daily, read and apply Functional Specific Document (FSD) - ANSWER-detailed doc w/tables, names of files. etc. Accumulation Files - ANSWER-DSNP are excluded, MOOP accums sent daily to PBM, 9M layout format; outbound is all medical; "sending medical dollars in a format Dual Eligibility - ANSWER-entitled to Medicare (always primary payor) and Medicaid HEDIS - ANSWER-measures quality of the care at a particular plan Individual Care Plan (ICP) - ANSWER-for DSNP members, a plan for care and goals for care
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Institution
Wellcare
Course
Wellcare
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Written for
- Institution
- Wellcare
- Course
- Wellcare
Document information
- Uploaded on
- August 28, 2023
- Number of pages
- 1
- Written in
- 2023/2024
- Type
- Exam (elaborations)
- Contains
- Questions & answers
Subjects
- wellcare
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wellcare notes 202323 with complete solutions
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