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Level 2 - Enrollment & Providers
Quiz by Ashley Jones
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​What enrollment period runs from January 1 through March 31 every year?
ICEP
MAOEP NEW
MAOEP
AEP
​What enrollment period runs from October 15 through December 7 every year?
AEP
MAOEP
ICEP
MAOEP NEW
What enrollment period runs from January 1 through March 31 every year?
What enrollment period runs from October 15 through December 7 every year?
For how many total months does an individual's ICEP run?
Which of the following are examples of SEP qualifying events?
A member calling to cancel their application before the effective date is classified as a disenrollment.
When leveraging the MARX system to complete research for a member, what STC is used to document that action?
You will use STC CP009 when a member request a replacement ID card.
The Benefits Grid will list a member's applicable Part B Premium Reduction as a:
Which of the following is NOT an acceptable means by which a member can request to disenroll from CarePlus?
Categorize the providers:
Match the maximum distance requirement with the County and Provider.
What is the mailing timeframe for a replacement member ID card?
How long is the standard mailing timeframe for a printed Provider Directory?
Randall Cunningham's Part A became effective on 01/21/2021. His Part B wasn't effective until 03/18/2021. He selected Humana Medicare Advantage plan at the time of enrollment, but now wants to switch to CarePlus. Under the MAOEP NEW election period, what is the latest date Randall can apply for enrollment into CarePlus?
Sheryl Crow called in on 07/26/2021 requesting to change her PCP, and that she will need to be seen by the new PCP next month ahead of overseas travel. What PCP change will you file?
Which STC would you use to document a PCP change that can be completed at the time of the member's call?
Providers listed on the Preclusion List are excluded from receiving payment for MA items and/or services beginning 60 calendar days after appearing on the List.
ICRs are able to process a telephonic plan change after determining that a member is within an eligible enrollment period.
The Par Provider Grid uses the assigned PCP's region code to determine the correlating Provider Network Coverage for each specialty.
Which Authorization Code matches this description:Â "PCP must send authorization request to CPHP-HSO along with medical notes for determination."
THE STRATEGIC PLAN OF RICHARD BLAND COLLEGE OF WILLIAM & MARY 2020-2025 “The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew and act anew.” – Abraham Lincoln What is the role of a selective, two-year, residential, liberal arts transfer institution within the higher education landscape of the Commonwealth of Virginia? This is a key question that must be answered to ensure the success of Richard Bland College (RBC) and the constituency that the College serves. The 2020 RBC strategic plan’s primary objective is to answer that very question so that the College, the community and the Commonwealth can engage successfully within this identity and purpose to the benefit of all. RBC has long been identified as the hidden gem of higher education in Virginia. The hidden adjective is based both on its relative obscurity—few are aware of RBC outside the Tri-Cities region—and its rural setting featuring 750+ acres of wetlands, bucolic forest, and the state’s oldest and largest pecan grove. Additionally, on average, a student of Richard Bland College travels a mere 36 miles to campus. This keeps the knowledge of RBC in a tightly focused radius. The gem moniker refers both to the College’s reputation for excellence and the undeniable sensation that the campus often elicits in its students, visitors, faculty and staff, the feeling of a warm and palpable embrace of care, compassion and support. That sensation is where we start. According the State Council of Higher Education for Virginia (SCHEV), 99% of the 11.5 million new jobs created since the great recession require workers to have more than a high-school education. Students with a bachelor’s degree have an earning potential almost double that of people with only a high school education, and yet only 17% of residents in the Petersburg area have a bachelor’s degree, 15% below the national average. The obstacles in the way of education have been exhaustively researched and include financial challenges, academic under-preparedness, low self-esteem, slow college assimilation and immature levels of self-efficacy. To combat this growing problem, Richard Bland College initiated a pilot program to determine the viability of a data-driven approach to improve retention and graduation rates. The program ultimately effected a cultural, organizational and operational shift at RBC, resulting in a personalized model of student support, the Exceptional Student Experience (ESE@RBC). Originally many of the practices that RBC used as the basis of ESE@RBC were adapted from the four key principles found in the American Association of Community Colleges (AACC) Pathways Project: 1) map pathways to student end goals; 2) help students choose and enter a program pathway; 3) keep students on path; and 4) ensure that students are learning. Unfortunately, limited resources made it necessary to skip some primary elements of guided pathways and instead to focus on a specific, high-priority project that was immediately available for implementation, dedicated student support. This strategic framework reimagines the way that RBC serves students, faculty and staff within the context of our existing culture, the principles of guided pathways and a hybrid work-college experience. Rather than thinking of a two-year college as a pipeline to a four-year university, this vision describes a more expansive menu of well-defined pathways to high-demand fields, all radiating from a curriculum constructed around the development of soft skills that define the liberal arts experience: critical thinking, written communication, analytical reasoning, civic engagement and oral communication. Furthermore, the impact of meaningful work is a resonating theme, providing avenues to participate in career-focused internships and jobs that develop important life & work skills, confidence, and character. Richard Bland has tested its entrepreneurial mettle and its capacity for transformation in recent years. The College was among a select few Competency-Based Education sites established by the U.S. Department of Education. We were ahead of the curve using predictive analytics to improve student retention and success rates, and online enrollment now makes up nearly 20 percent of course offerings. It may be counter-intuitive, but these and other deep-level institutional changes still to come will ensure that Richard Bland College remains true to its original mission. We prepare our students for a lifetime of endless potential.Management and Globalization Global Management Why companies go global How companies for global Global Business environments Global Business Types of global business Pros and cons of global businesses Ethnic Challenges for global business Culture and Global Diversity Cultural intelligence Silent language of culture Tight and loose cultures Values and national cultures Global Management Learning Are management theories universal? Intercultural competencies Global learning goals Key concepts of the challenges of globalisation: Global economy Resources, markets and competition are worldwide in scope Internationalisation The process of increasing involvement in international operations Globalization/Deglobalization Glob- the growing interdependence among elements in the global economy The worldwide interdependence of resource flows, product markets and business competition World 3.0 Different views: World flat vs. round Distance is a metaphor that represents the degree of dissimilarities between countries Balancing cooperation in the global Global Management Global management - managing things in different countries Managing business and organizations with interests in more than one country What do we expect from global Managers Knowing how to adapt Knowing the language Global Manager Is culturally aware and informed on international affairs International Business Conducting for-profit transactions of goods and services across national boundaries International Motive Why do firms internatioalize their activities Cheaper labour Labour tax Natural resources Enrolments to do business Clientele Exclusive materials Personal benefits: Taxes Reasons why businesses go global Customers Suppluers Capital During (1993) - 4 motive 1. Market seeking 2. Efficiency Seeking 3. Resource seeking 4. Strategic Asset Seeking Cuervo Cazurra, Narula and un (2015) - 4 motive s Internationalization Motives A company may also explore the opportunities in different markets in order to take advantage and in some cases extend the product life cycle What is a Market Entry Strategy Involves the sale of goods or services to foreign markets but do not require expensive investments Franchising Exporting and importing Involve the sale of goods or services to foreign markets but do Types of market entry strategies Global sourcing Exporting Importing Licensing agreement Franchising Types of Foreign Direct Investment (FDI) strategies: Joint venture Strategic alliance Owned Subsidiary (sometimes called WOS) How to go abroad What conditions will affect the decisions of firms on how to internationalize their activities? During (1978)- Eclectic paradigm OLI model OLI- Ownership, Location and Internalization Advantages Ownership advantages Resources owned by the organization that can be transferred across locations include trademarks, production techniques and processes, managerial skills and other resources not available to the competitors Location Advantages Represent the implications of choosing to produce or to perform activities in a specific location (country or region) Internalization Advantages: The ability to internalize or to incorporate activities that add value to its business Evolution of Concepts- New Elements Although economic factors are certainly important to explain the formation, growth and expansion of firms within and across national borders, they are not sufficient to explain the additional complexity when a firm decides to expand its activities across national borders Economic factors Investigate the economic elements that affect the internationalization of firms Behavioural Elements Explaining the additional challenges (and perhaps opportunities) a firm faces in foreign host countries when compared to indigenous (local) firms Behavioural theories Johanson and Wiedersheim-Paul (1975) and Johanson and Vahlne (1977) Included the psychic Distance concept (beckerman,1956) to explain the internationalization behaviour of firms The Uppsala internationalization model Psychic distance is: the sum of factors preventing the flow of infomatio from and to the market Psychic Distance is a broad concept that includes several elements such as: language, culture, political systems, level of education, level of industrial development Firms behave in a “Risk Averse” manner It means that when the perceived risk goes down, the firm increase its commitment to the foreign market \ The Haier Group Data Strategy Big DATA and Small DATA The use of small data to satisfy individual customers’ needs, however, the book mentions a huge cultural shock at the plant in Camden, south caroline Ex: top down, hard hat colors and hierarchy Culutral Differnces can have a huge impact on the internationalization of firms Kogut and Singh (1988)- Cultural Distance Index First statsical study on the implication of ciltiral distance to the selection of entry mode When investigating in culturally distant countries, foreign firms can choose to partner with foreign firms in order to gain local knowledge and share the risk associated to the investment (higher commitment = higher risk) How Companies Go Global Global sourcing The process of purchasing materials or services around teh world for local use Exporting Selling locally made products in foreign markets Importing Buying foreign made products and selling them domestically Exports correspond to what percentage of Candain GDP What countries are the major trending partners of Canada Management and Globalization How Companies Go Global Licensing Agreement One firm pays a fee for rights to make or sell another company’s products What are the potential risks associated to licesning The case of new balance in China Franchising A fee is paid for the rights to use another firms name, branding and methods Insourcing Insourcing: refers to local job creation that results from foreign direct investment Types of insourcing Joint ventures: operate in a foreign country through co-ownership by foreign and local partners Strategic alliances: A partnership in which foreign and domestic firms share resources and knowledge for mutual gains Foreign subsidiaries: local operation completely owned by a foreign firm Criteria for choosing a joint venture partner: Familiarity with your firm’s major business String local workforce Values its customers Future expansion possibilities Strong local market for partner’s own products Good Profit potential Sound financial standing Global business environments Legal and poliical systems Trade agreements and trade barriers Regional economic alliances Legal and political systems Differing laws and practices regards Business ownership Negotiation and implementation of contracts Foreign currency exchange Protection of intellectual property rights Counterfeit merchandise Political risk Potential loss in value of foreign investment due to instability and political changes in the host country Political risk analysis (expertise/experience) Forecast political disruptions that threaten the value of a foreign investment Changes in the rules of the game Brexit US Trade Wars-mexico-China Other examples Bolivia, Venezuela, China De-globalization The process of weakening interdependence among nations Trade Agreements and trade Barriers World trade organization Most favourd nation status Tariffs Nontariss barriers (quotes, restrictions, etc.) Protectionism Regional Economic Alliances USMCA (replacment for the NAFTA-North American Free trade Agreement) EU- European Union APEC- Aisa Pacific Economic Copperation ASEAN - Association of Southeast Asian Nationas SADC - Southern Africa Development Community MERCOSUR- Chapter 5- Global Management and Cultural Diversity (part 2) Review Types of global business Global corporation MNE (multinational enterprise) or MNC (multinational corporation) with extensive business operations in more than one foreign country Transnational corporation A global corporation that operates worldwide on borderless basis Some host country complaints about MNCs Host Country companits about MNCs: Excessive profits Interference with local government Domination of local economy Interference with local government Hiring the best local talent Limited technology transfer Disrespect for local customers Examples - War in Ukraine Disruption in global -value chains and increased pressure and interference of MNCs with local government Fertilizer imports in Brazil (one of the major producers of agricultural commodities) We must consider the triple bottom line and the impact in society, the environment and the economy $2.5 billion invest in potash mine in Brazill What about Globalization gap Large multinationals adn industrilizednaitons gaining disporoportinonally form globalization Globalization gap: Large multinational and industrialized nations gaining disproportionally from Globalization Some MNC complaints about host countries MNC Complaints about host countries: Profiit limitations Laws and regulations Overpirce resources Exploitative rules Foreign exchange restriction Failure to uphold contracts Mutual benefits for host countries and multinational companies Mutual benefits for host country and global corporation of MNC: Shared growth opportunities Shared income opportunities Shared learning opportunities Share development opportunities Develop projects together What are some of the ethical challenges for global business Ethincal challenges for global business Child labour Employmnet of children for worl otherwise done by adults Sweatshops Employment of workers at very low wages for long hours in poor working conditions Ex: Nike bad labour prices Unsafe working conditions Corruption Illegal practices that further one’s business interests Corrupiotn of froeign public officials Act makes it illegal for Candain firms and their representatives to engage in corrupt practices overseas Bribes to foreign officials Excessive commissions Non-monetary gifts Sweatshops Conflict materials What is culture Culture : The shared set of beliefs, values, and patterns of behvaiourr common to a group of people Food preferences Values and traditions Language and beliefs Religion Art music Life style Hofstede defines culture as: “The collectiv programing of teh mind distinguishing the members of one group or category of people from others” What is culture shock Culture Shock: Confusion and discoumfert a person experiences in an unfaamiliar culture Stages to adjusting to a new culture Confusion Small vitorires The honeymoon Irritation and anger Reality Cultural Intelligence The ability to adapt and adjust to new cultures What is Ethnocentrism Tendency to consider one’s own culture as superior others Slinet languages of culture Contect Low context High context Space Proxemics Ex: personal space Time Monochronic Polychronic High and low contexts cultures Edward T.Hall (1959) Def: Part of a discourse that surround a word or passage and can throw on its meaning Low context cultures Emphizes communication via spoken or written words Countries like United States, Canada and Germany High context cultures Rely on nonverbal and situational cues as well as on spoken or written works Thailand Malaysia Time Monochronic cultures People tend to do one thing at a time Canda Polychronic cultures Time is used to accomplish many different things at once Egypt Space Proxemics Study of how people use space to communicate In North American people value “personal space’ Many Latin and Asian cultures expect much less personal space Tight and Loose Cultures Cultural tightness-looseness Tight = Strength of norms that govern social behvaviour Japan, Korea, Malaysia Loose = tolerance for any deviation from norms Australia, Brazil, Hungary Values and national cultures (Hofstede) Power distance Uncertainty avoidance Individalism-collectivism Masculinity-femininty Time Orientation Indulgence vs. Restraint Comparative management How management pratices systematically differ among countries and /or cultures Intercultural competencies Skills and personal characteristics that help us be successful in cross cultural situations Global Managers (know how to adapt) Need to successfully apply management functions across interantional boundaries Global Learning goals Not universal Engage critical thinking Look everywhere for new management ideas Always consider culture LEVEL 2LEVEL 2#Level 2 spellingLevel 2 Quiz on the Capital Market DynamicsLevel 2 Grammar_Present SimpleLevel 2 CB List 2 Vocab Practice by Olga Spuskanyuk