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.
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.
