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ACOM3 Application Tracker User Manual

1. Writing Agent Number Writing Agent Name 1 1 1 1 1 6 1 y IND Iw ts Id IW O Click on an underlined AWN or of Apps for TAT total to view a more detailed report of the applications within the range chosen for the particular agent and their specific TAT Da Applications By Agent By Turn Around Time Summary of all Applications grouped by Agent by Turn Around Time For Cont Market Revd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 Please Note This report will produce no more than 5000 records For Agent is Cont Market Current Home Off Application Tracking Rcvd Date Member Name TAT Calc Date Rcvd Date Number Turn Around Time Product TAT is More Than 2 Days 31 12 16 2011 Total 1 11 15 2011 12 16 2011 TEAS CCP GEORGIA TAT Within 2 Days m 1 1 1 1 1 1 0 o 0 0 0 0 Total Total for Report 13 14 10 21 2011 12 01 2011 03 07 2012 10 21 2011 10 26 2011 11 16 2011 10 27 2011 12 01 2011 10 17 2011 12 06 2011 11 29 2011 12 07 2011 10 21 2011 10 20 2011 11 30 2011 03 06 2012 10 20 2011 10 25 2011 11 15 2011 10 26 2011 12 01 2011 10 17 2011 12 06 2011 11 29 2011 12 07 2011 10 21 2011 10 21 2011 12 01 2011 03 07 2012 10 21 2011 10 26 2011 11 16 2011 10 27 2011 12 01 2011 10 17 2011 12 06 2011 11 29 2011 12 07 2011 10 21 2011 ARQ A ARQ ES A AAA RADO A RACER HOE A CCP GEORGIA CCP GEORGIA CCP GEORG
2. If the user has a different payee different SSN or TIN their commissions will only display in their payee s App Tracker Lec ENTRY Fep Tape welcome Provides a list of the Payment Youchers from most current to least current Each Payment Adjustments that comprise that Payment Voucher Starting Date 04 27 2011 kij The Payment Vouchers will be selected from the current date back to the value specified for the Starting Date The default is to display the Payment Vouchers for the last year This can be overridden by entering your own Start Date If you have authority to multiple Payees you can limit the Payment Vouchers selected to a specific Payee by entering the Payee s AWN Financial Entity Y By default Payment Vouchers for all Financial Entities will be selected You can limit the Payment Vouchers to a specific Financial Entity by selecting the appropriate value Run Report Clear Payment Summary Summary of Payment Vouchers for 1 Please Note This rept will pros no more than 500 records Process Date Date Payee Extracted to Year Generated AP 2012 04 12 2012 04 12 2012 2012 04 06 2012 04 06 2012 2012 Do 03 30 2012 2012 03 22 2012 03 22 2012 2012 03 15 2012 03 22 2012 2012 03 08 2012 03 08 2012 2012 03 03 2012 03 03 2012 2012 03 01 2012 03 01 2012 2012 02 26 2012 02 26 2012 2012 02 16 2012 02 16 2012 2012 02 11 2012 02 11 2012 Payee Name Balance Forward KE PE traba 0 00 14 832 55 0 00 0 00 3
3. Paro 12 07 2011 12 We Production Adiustmeny PAID 11 30 2011 11 vie Production Adjustnghts i View Nroduction Adjustfients i Page 49 ACOM3 Application Tracker User Manual App Tracker is configured to display statements for 6 periods which are defined as months To view statements older than 6 periods click Find at the bottom of the statement screen to reveal the search options at the top of the screen TA seteme gt ERE amp Vendor Statements Bill Bill Date Date Payee P N Busi T FinancialBalance Field Adj Year Month Generated Released Number 9Y Name SANDSS UPPE Entity ForwardiCommissionsi 2009 12 12 11 2009 12 11 2009 47570 FIRST HEALTH LIFE AND HEALTH Medicare 00 30 18 00 j 2009 10 10 09 2009 10 09 2009 a 47570 FIRST HEALTH LIFE AND HEALTH Medicare 00 30 18 00 Enter the bill year and bill month and press the Enter key For instance to see statements for January 2012 enter 2012 in the bill year field and 1 in the bill month field press Enter and the statements for that period or month will be displayed on the lower portion of the screen ints Letters A oy Vendor Statements Bill Month Type All vendors Broker PSoft Check Number fo O PSoft Check Status PSoft Check Date 3 Psoft Check Reconciliation Date O En Bill Bill Date Date Payee P N Riel T Financia Year MonthlGenerated Released Number YES Name AA Entity miz 1 D1F27 2012 02 11
4. 30 00 0 00 0 00 30 00 men 0 00 0 00 0 00 0 00 MEDICARE PART D 755 83 4 340 66 0 00 5 096 49 PDP REFERRAL 67 00 0 00 0 00 67 00 Part D Retail Sales Program 0 00 0 00 0 00 0 00 PRIVA TE FEE FOR SERWICE 9 471 24 594 01 0 00 10 065 25 Total 10 190 07 4 934 67 0 00 15 124 74 PRODUCT First Year Payments Renewal Payments Click on an underlined Product link to generate the summary list of commissions that have been forfeited for the chosen Product Ba Payments Forfeited Listing of Transactions that have been Forfeited For PRODUCT CCP GEORGIA Please Note This report will produce no more than 500 records Receiving Agent Writing Agent Application Tracking Member Name Product Plan Name Effective Number Date AWN Name AWN Name 1 B CCP GEORGIA Advantra Elite GA 01 01 2011 HMO 1 B CCP GEORGIA Advantra Elite GA 01 01 2011 HMO Page 39 ACOM3 Application Tracker User Manual 2 13 Forfeited Payment Details The Forfeited Payment Detail report provides details on commissions that have been forfeited The user may utilize six 6 filters to retrieve payment summary information Receiving Agent AWN Writing Agent AWN Product Forfeit Reason See 5 1 for Forfeiture Reasons Forfeit From Date Forfeit To Date K X XXX K This report also provides the ability to prioritize the sequence of the report by the use of a Primary Sort Order and Secondary Sort Order The option
5. Clear Most of the screens will have required fields These fields can be entered manually or they can be populated through the use of the calendar icons which appear to the right of every date field or through the use of a drop down menu y Fields that are entered manually are not case sensitive y Fields that are required are highlighted in yellow Less E N TRY Froli Taps welcome Application Specifics The Application Specifics report provides the ability to search for specific member Applications and The detail information includes Summary of Payments Transactional Payment Information by Agent m 4 Calendar icon From Cont Market Revd Date 1001 2011 This section was formerly tiled From Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the earliest Application Receive Date to consider when selecting the Application information To Cont Market Revd Date 10 14 2012 kii This section was formerly tiled To Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the latest Application Receive Date to consider when selecting the Application information From Effective Date 10012011 3 The Application information selected can be limited based on the member s Enrallment Effective Date This parameter dictates the earliest Enrollment Effective Date to consider wh
6. HICN Displays member s HICN Medicare ID on file Member ID Displays member s internal member ID NOT the policy ID Member Name Displays member s name Product Displays the product of the member s policy Effective Date Displays the effective date of the member s policy Term Date If the member s coverage is terminated this displays the termination date Term Reason This displays the internal reason code for termination See 5 1 for Termination Reasons Rapid Disenrollment Displays a Yes or No value to indicate if termination was a rapid disenrollment Coverage Period The month of coverage of which the payment addresses Payment Status This indicates if payment was not held held released if previously held and forfeited Payment Amount This indicates the amount of the commission either positive or negative displayed in red with parenthesis Explanation Categorizes the payment type For example if the payment was a negative value the explanation is Chargebacks Date Paid Displays the Statement date of the payment Hold Reason If the payment is being held this displays the hold reason Writing Agent Name Displays the name ast name first name of the Agent of Record Writing Agent AWN Displays the Agent Writing Number of the Agent of Record Page 43 ACOM3 Application Tracker User Manual 2 15 Negative Balances The Negative Balance report provides information in the event that the user currently has
7. Periods 10 01 2011 12 31 2012 For Product PARTD Adjustment Description Product Adjustment Amount 2012 AHIP Certification Reimbursement for PARTD MEDICARE PART D 100 00 2012 AHIP Certification Reimbursement for PARTD MEDICARE PART D 100 00 Reverse charge backs on NES PARTD MEDICARE PART D 31 00 Total 231 00 On the Payments Summary by Product Manual Adjustment Summary report the 5 data fields listed below will be present Adjustment Description Product Year Month Adjustment Amount Ne NE UU Page 32 ACOM3 Application Tracker User Manual 2 9 Payments By Month The Payments by Month report provides a summary and graphical representation of the payments by month for a given year The report also provides access to additional details on Manual Adjustments related to each payment month The single required field for this report is the Year The system default for this field is the current year eov EW TR YW Frollo Faso Welcome Provides a Summary and Graphical representation of the Payments by Month for a given year each Payment Month Year blo Specify the Payment Year for which the report is to be generated Run Report On the Payments by Month report the 5 data fields listed below will be present Y Month First Year Payments Renewal Payments Manual Adjustments Monthly Totals K XX XK Page 33 ACOM3 Application Tracker User Manual Payments Summary by Month Fo
8. Revd Date 10 14 2012 kti This section was formerly tiled To Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the latest Application Receive Date to consider when selecting the Application information From Effective Date 10 01 2011 kij The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the earliest Enrollment Effective Date to consider when selecting the Application information To Effective Date 12 51 2012 kti The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the latest Enrollment Effective Date to consider when selecting the Application information Page 12 ACOMI3 Application Tracker User Manual The App Specifics report also provides the ability to prioritize the sequence of the report by the use of a Primary Sort and Secondary Sort The options listed below appear in the drop down menu for each sort Member Name Primary Sort system default Application Tracking Number Secondary Sort system default Agent Name Agent Writing Number AWN Health Insurance Claim Number HICN Application Date Product Turn Around Time SH NR NRE NRE EEN Application Tracking Number Page 13 ACOM3 Application Tracker User Manual Below is an example of the App Specifics report as it will a
9. The system default date is 10 14 2012 From Effective Date The system default date is 10 01 2011 To Effective Date The system default date is 12 31 2012 Ki KIA eo YEMTRY Froli fare Welcome a Applications Turn Around Time Summary of Applications by Turn Around Time From Cont Market Revd Date 10 01 2011 k This section was formerly tuted From Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the earliest Application Receive Date to consider when selecting the Application information To Cont Market Revd Date 10 14 2012 ki This section was formerly titled To Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the latest Application Receive Date to consider when selecting the Application information From Effective Date 10 01 2011 k The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the earliest Enrollment Effective Date to consider when selecting the Application information To Effective Date 1231 2012 Ktj The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the latest Enrollment Effective Date to consider when selecting the Application information Run Report Clear Page 45 ACOM3 Application Tr
10. To limit the report to the Policies associated to a specific Product enter that specific Product This is an optional parameter When a value is specified the value must exactly match the Product for the Policies to be selected Membername O To select Policies based on Name enter a full or partial name value When a value is specified Policies with a Member Name value that contains the specifed value will be selected For example you can enter Smith to get all all names containing Smaith Run Report Clear Page 42 ACOM3 Application Tracker User Manual Totals will be shown only for a single unique member and not if multiple members exist within the search results y For example lf the user sets the search criteria with a certain From and To Effective date AND a Member ID the results will not only show each transaction for that member but show a Total sum of those payments For example lf the user sets the search criteria with a certain From and To Effective date AND selects a specific Product the results will show any member falling under the chosen criteria and any associated transactions However there will not be a Total sum of those transactions D MPO ant MPO art MPO art MPO at MPO at MPO art MPO EDI MPO at MPO at MPO at MPO at MPO art On the Payment History by Member report the 16 data fields listed below will be present lt lt lt K lt lt lt x lt lt LILAK REE
11. specified date Product Specify the Product for which the report is to be generated State Specify the State for which the report is to be generated Run Report Page 17 ACOM3 Application Tracker User Manual The following is an example of the Applications by Status report as it will appear on the App Tracker screen after search criteria has been chosen and the report has been run Applications By Status Summary of Applications by Application Status by Product by State For Cont Market Revd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 RAPID DISENROLL 1 PRE ENROLLMENT 36 CANCELLED 163 Na i ACTIVE 1479 ACTIVE CANCELLED PRE ENROLLMENT RAPID DISENROLL TERMINATED PRE RAPID Total for TAT Within TAT is More ACTIVE CANCELLED ENROLLMENT dISENROLL TERMINATED Product State Than 2 Days 6 G r 1 1 1680 1679 1 36 1680 1679 PARTD NY x Total for PARTD 47 6 1680 Total by Status 16 36 1680 The pie chart feature allows a user to click on any part of the graph to generate that portion of the report the graph represents For instance select the red portion of the pie chart to generate the Application by Status report for applications with an Active status The lower portion of the report displays various information in both columns and rows The columns are categorized by y Application Status one column for each status represented
12. will not receive renewal commissions Payment Period 02 26 2012 03 03 2012 SUMMARY INDIVIDUAL BUSINESS Product First Year Overndes Renewal Overndes INDIVIDUAL BUSINESS SUMMARY Page 54 ACOM3 Application Tracker User Manual Click on the underlined Production link and a Detail by Agent Writing Number and Product production report is generated Production Customer Number Amount Amount Bill Bill Broker Collected lPaymentMonthiYear Number dle Date Paid Full Name Business Type 20000 CHC OF GEORGIA HMO 04 12 2012 04 12 201 04 12 201 04 12 201 04 12 201 04 12 201 04 12 201 04 12 201 04 12 201 04 12 201 04 12 201 p 04 12 201 E 2012 1 E 2012 1 T 2012 1 E 2012 1 E 2012 1 R 2012 1 E 2012 1 E 2012 1 E 2012 1 A 2012 1 E 2012 1 EAMA AAAA AAA AAA AAE AAE EAE EAE tor ton ten o D H rm rm o H NNNMNNNNN NM N NNN NN NM NM NP MN E 2012 1 Click on the underlined Adjustments link and an Adjustments report is generated This report provides details on any manual adjustments applied to an agent s commission statement Adjustments Broker Payee Customer Amount Adjustment Full Name Payee Name Name Adjustment Description Number Number Number PaymentType 1 O 1 q MPD 31 00 Forfeit Reversal Reverse charge backs on for first year commissions Page 55 ACOM3 Application Tracker U
13. 000 CHC OF GEORGIA HMO 207 rf 22 5 2 2 47170 FIRST HEE FE 011 12 12 13 2011 12 13 2011 20000 CHC OF GEORGIA HMO 20000 CHC OF GEORGIA HMO E A 7170 FIRST HEALTH LIFE AND H a 5 pi 011 12 12 05 2011 12 05 2011 i j f of of y or in A a bab j l O11 11 11 28 2011 11 28 2011 NI Ni 1 Bab 4 011 11 11 17 2011 11 17 2011 DN PAE ae 47170 FIRST HEALTH LIFE AND H The first report column on the Statements screen is Bill Year Click on the year and the Statement Detail will be generated co VENTRY Peotte face Welcome Statement Detail Payee Number MN A Broker Number Per Year 2012 Per Month Status Printed Run ID DatTo Type Vendor E Mail LastEMailDate 04 23 2012 PSoft Check Number PSoft Check Status PSoft Check Date 04 24 2012 PSoft Check Reconciliation Date View Statement Medicare Payment Statement COVENTRY fesith Core Medicare Commissions Reminder Terminated agents will not receive renewal commissions Payment Period 04 08 2012 04 14 2012 The lower portion of the screen contains the commission statement On the upper portion of the screen click on View Statement to see the entire statement in anew window Page 51 ACOM3 Application Tracker User Manual The PDF tool bar at the top of the new Medicare Payment Statement screen will allow the user to manipulate their view of the report Comment Sign Medicare Paym
14. 012 3 Specify the date for which the report is to be based Po To review the contracting status for a specific Agent enter the AWH in this field To review the contracting status of Agents with a particular name value enter a full or partial name value in this field AWN Agent Name Agent Status Page 25 ACOM3 Application Tracker User Manual Le OVENTRY feotte face Welcome Reports Statements Letters Demographics Reports A la App Specifics Check For Application Please Note This report will produce no more than 5000 records Apps By Status MISSING data indicates agent has not completed contracting process and payments will not be paid Apps By Agent By Status Agent Roster Agent Contracting Status As of 04 27 2012 Agent Status Date VIEW LOA Active 10 15 2011 VIEW Ready Contract To Sell Demographic Hierarchy Agent SSN k E last 4 digits Deme Information Level Status Certification Payments Summary 8 Payments By Product 6 Payments By Month Held Payments Summary 3 3 VIEW LOA Active 10 15 2011 VIEW VIEW LOA Active 10 15 2011 VIEW Held Payment Details Forfeited Payments Summa Forfeited Payment Details Payment History By Membe Negative Balances pee ai No AWN will appear for agents Ardo ra with MISSING listed under any item that is incomplete amp needs to be submitted completed to be fully contracted amp R
15. 06 00 0 00 0 00 213 74 0 00 284 38 2 053 08 0 00 0 00 284 38 0 00 0 00 11 878 85 0 00 0 00 488 00 0 00 0 00 40 84 0 00 0 00 917 86 0 00 0 00 61 26 0 00 0 00 12 418 33 0 00 Page 28 pop pp pl pl pl pl pl pl ps ACOM3 Application Tracker User Manual On the Payment Summary report the 16 data fields listed below will be present Process Year Process Month Date Generated Date Extracted to AP Payee ID Payee Name Balance Forward Payment Calculated Manual Adjustments Net Amount Paid Financial Entity Check ACH Check ACH Date Check ACH Status Month Paid Reference Number Sh Gh Gh Gk Gh Gk Ge Gk Gk Gh Gh Ge Gh US UA Click on the underlined date in the Date Generated field to view the Voucher Statement Details report as shown below Y E Payment Summary Voucher Details Payee Id A Payee Name AS Process Year 2012 Process Month 04 Date Generated 04 06 2012 Date Extracted to AP 04 06 2012 Financial Entity Medicare Reference Number 13 Check ACH iii Balance Forward 0 00 Check ACH Date 04 10 2012 Payments Calculated 306 00 Check ACH Status PAID Manual Adjustments 0 00 Check Recon Date 4 Net Amount Paid 306 00 Payment Summary by Agent Payment Transaction Details Payment Manual Adjustment Details The three links in blue across the bottom of this report will open more detailed sub reports Page 29 ACOM3 Application Tracker
16. 2012 0000 CHO OF GEORGIA HMa Medicare 2012 012042012 01 20 2012 47170 FIRST HEALTH LIFE AND HEALTH Medicare 37000 CH amp L 1 06 2012 0106 2012 47170 FIRST HEALTH LIFE AND HEALTH Medicare Fi Hide Find i To view the full listing once again clear the data from the month and year fields and press Enter Page 50 ACOM3 Application Tracker User Manual coventry feotte lar Welcome Administrator Integration Credentialing Statements Letters Demographics History 3 v Vendor Statements Letter History i Bill Bill Date Date Payee Year MonthiGenerated Released Number 2012 4 04 20 2012 04 20 2012 47170 FIRST HEALTH LIFE 4ND H 2012 04 12 gt 04 47170 FIRST HEALTH LIFE AND H 2012 4 04 06 2012 04 06 2012 4 7170 FIRST HEALTH LIFE AND H 47170 FIRST HEALT E AND H E 7170 FIRST HEALTH LIFE AND H an CH GEORGIA HI 2012 2019 13 47170 FIRST HEALTH LIFE AND H 1 FIRST HEALT FE ANI Payee Name Business Type 2 3 Ma 03 22 2012 03 22 2012 2012 03 08 2012 03 08 2012 47170 FIRST HEALTH LIFE AND H i RS Ef E AND E E 7170 FIRST HEALTH LIFE AND H oc H F GE HI 20000 CHC OF GEORGIA HMO gt EAL E AN MEAS UES I 37 U 1 i 2012 02 26 2012 02 26 2012 2012 2 02 16 2012 02 16 2012 2012 02 11 2012 02 11 2012 2012 i 012 l 2012 1 01 27 2012 02 11 2012 J ea 1 AL ll 2012 1 01 12 2012 01 12 2012 20 gt aT F 37000 CH amp L z DH re 011 12 12 29 2011 12 29 201 i 20
17. ACOM3 Application Tracker User Manual Kone OVENTRY Health Care Application Tracking System User Manual App Tracker This document is intended for use by Coventry Health Care contracted brokers and agents only and is not intended for distribution to Coventry Health Care members or potential applicants This information is confidential and any publication or distribution of it to unauthorized recipients without Coventry Health Care approval is prohibited 2012 Coventry Health Care Inc Last updated May 2012 Page 1 ACOM3 Application Tracker User Manual Table of Contents 1 Welcome to ADDIICALION TRACKER ccscorsvecacecacscocazecazacacacacanesasecanetaresacesacunacanacanearadazesecacaeacasanesacesasenas 3 1 1 initial EOI Tor First TIM amp US a e da a La o 4 O lO E A A ee 6 123 ADO racker MaN MONU AAA AA A 7 AB ASCANIO ANO da 8 2 ROpOorS T E 11 21 ADPIC NON SDC CIICS a3 iso a E a a a a aaa eee 12 RA NECIO RADICAN isa dadas idad dadas iii si 15 20 APPICAVONS DY SAUS tito 17 2 Applications By Writing Agent By AS aeeneeeneeet 21 2 9 AJ N OSO aa AAA aR 23 2 6 Agent COASTAL ta tdt AE TARA 25 Ze LS E 28 ZO MENS DIO E EAEE E A A AEE A E E o o o 31 29 Ay Mens DY MONU ar test esate detente tlt eather at suf aa sar ater else utente noO ada 33 2 10 Held Payments SUIMIMALY cccccccccccccecccsucccsucecseesseeesseeessesesseeesseeesseeeesenesseeesseeesseeesseessnsessneesaes 34 241 US A O 37 2 de PONCNEO Fayments SUMINGIY s
18. AL CARE PersonalCare Advantra Silver CCP PERSONAL CARE PersonalCare Advantra Silver CCP PERSONAL CARE PersonalCare Advantra Silver o F E F amp F F amp F FSF FS Payment Summary Manual Adjustments Detail List of Manual Adjustments for Payment Voucher Ts Selected Record Payee Id E A Payee Name A Process Month ol Process Year 2012 Date Generated 01 12 2012 Date Extracted to AP 01 12 2012 Reference Number 1 o O Adjustment Description Agent Id Agent Name Product Coverage Adjustment Year Amount 2012 AHIP Certification Reimbursement for Broker CCP PERSONAL CARE 100 00 2012 AHIP Certification Reimbursement for Broker CCP PERSONAL CARE 100 00 2012 AHIP Certification Reimbursement for Broker CCP PERSONAL CARE 100 00 2012 AHIP Certification Reimbursement for Broker CCP PERSONAL CARE 100 00 2012 AHIP Certification Reimbursement for Broker CCP PERSONAL CARE 100 00 2012 AHIP Certification Reimbursement for Broker CCP PERSONAL CARE 100 00 Totals 600 00 Page 30 ACOM3 Application Tracker User Manual 2 8 Payments By Product The Payments by Product report provides a summary and graphical view of payments by product based on the specified From and To date fields The system defaults for these fields are 10 01 2011 From Date and 12 31 2012 To Date den ENTRY Fendi Faso Welcome This report provides a Summary and Graphical view of the Payments by Product based details on Manual Adjustme
19. As of 05 01 2012 TF Wi ER En E all To access more detail when generating a report click on an underlined item within a report as shown below cov ENTRY Feott face Welcome Application Tracking Number Version 4 9 1 0 10 4Com3Cov Application Da 12 17 2007 ACTIVE 01 14 2008 ACTIVE 01 12 2008 03 20 2008 03 19 2008 12 12 2007 To run a report with new parameters click back onto the report title listed on the left hand side of the screen The report page will reappear with the same field settings from the previous report Page 10 ACOM3 Application Tracker User Manual 2 Reports Overview of Available Reports The first tab of the App Tracker menu is the Reports Tab The reports available to the user are listed on the left hand side of the screen Availability of reports will be based on the corresponding privacy and security levels assigned by Coventry For example y AWN based on Distribution Partner Marketing Organization or Admin Level 1 Access to all reports from all tabs for themselves and their down line activity y AWN based on agent contract level or Admin Level 2 Access to application information only See the Table of Contents for a complete list of reports that may be available in App Tracker feces ENTRY Peot le arre Welcome Application Specifics The Application Specifics report provides the ability to search for specific member Applicatio
20. By Status report are underlined Click on any of these numbers and a separate report will be generated by the application status selected Applications By Status List of Applications for specific Application Status and Product For Cont Market Rcvd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 For Application Status CANCELLED Please Note This report will produce nagfore than 5000 records tina wee A Writing Agent Name gears Tracking Member Name Product Plan Name AWN umber AEEEEEAIS MEDICARE PART D eNOS MEDICARE PART D i SS MEDICARE PART D HAIER MEDICARE PART D Retail Sales Program E20D MEDICARE PART D FH Premier 44699 MEDICARE PART D Retail Sales Program Ee DA MEDICARE PART D FH Premier Page 20 ACOM3 Application Tracker User Manual 2 4 Applications By Agent By Status The Applications by Agent by Status report provides the ability to view Applications grouped by Writing Agent and by Application Status The user may utilize four 4 filters to retrieve application status results y From Cont Market Revd Date The system default date is 10 01 2011 y To Cont Market Revd Date The system default date is 10 14 2012 y From Effective Date The system default date is 10 01 2011 y To Effective Date The system default date is 12 31 2012 The results may also be sorted by either Writing Agent Name or Writing Agent ID AWN Mec EWNTRYW Froli fare Welcome Utilize
21. From Effective Date 10 01 2011 ki The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the earliest Enrollment Effective Date to consider when selecting the Application information To Effective Date 1251 2012 ki The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the latest Enrollment Effective Date to consider when selecting the Application information Sort Order writing Agent Id Y Run Report Clear Page 47 ACOM3 Application Tracker User Manual The report columns are categorized by Writing Agent Number Writing Agent Name Agent Level Turn Around Time of Applications for Turn Around Time AA UA A a Applications By Agent By Turn Around Time Summary of Applications By Agent By Turn Around Time For Cont Market Revd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 Please Note This report will produce no more than 5000 records of Applications for Turn Around Time Turn Around Time Agent Level PFFSAG4 TAT Within 2 Days LOA TAT Within 2 Days PFFSAG4 TAT Within 2 Days PFFSAG4 TAT Within 2 Days PFFSAG4 TAT Within 2 Days PFFSAG4 TAT Within 2 Days LOA TAT Within 2 Days LOA TAT Within 2 Days LOA TAT Within 2 Days LOA TAT Within 2 Days PFFSAG4 TAT Within 2 Days PFFSAG4 TAT is More Than 2 Days PFFSAG1 TAT Within 2 Days
22. IA CCP GEORGIA CCP GEORGIA CCP GEORGIA CCP GEORGIA CCP GEORGIA CCP GEORGIA CCP GEORGIA CCP GEORGIA CCP GEORGIA CCP GEORGIA Page 48 ACOM3 Application Tracker User Manual 3 Statements Letters 3 1 Vendor Statements The second tab on the App Tracker menu gives the user access to the Broker Commissions Statements and Letter History To access Statements click on the tab labeled Statements Letters and choose Vendor Statements on the left hand side of the screen Note A user will only be able to view their commission statements if they are set up to pay to themselves and not to another payee or agency E Demographics Bill Bill Date Date Payee PayeeBusinessFinancialBalance Field Adjustments Adjustments N Payment P20 PSoft PSoft e et YearMonthGeneratedReleasedNumberName Type Entity ForwardPayments a E Sera inna a Users will see there are four columns in the Statements menu that are underlined and will generated reports when chosen The first underlined field in the menu is the statement year under the Bill Year column The View statement Production and Adjustments fields listed at the far right hand side of the menu also generate additional report details when chosen Click on any of these four fields to generate further detailed statement reports FinancialBalance Field AdjustmentsiAdjustments Forward Payments 5 PAID 04 10 2012 4 vie ion Adjustmdgts PAID 03 27 2012 3 yv
23. LOA ACTIVE LOA CANCELLED LOA ACTIVE 56005050000 Page 21 A Application Status ACTIVE Q ACOM3 Application Tracker User Manual On the Applications by Agent by Status report the 8 data fields listed below will be present y Agent Writing Number Name agent Agent Level of Applications for Status Total for Product State KXXX MESES TAT Within 2 Days turn around time TAT is More Than 2 Days turn around time Application Status one column for each status represented in the chart Active Terminated Pre Enrollment Rapid Disenroll Cancelled Click on an underlined Agent Writing Number and a more detailed report will be displayed The Applications by Agent by Status report below displays applications in each of the five 5 categories Active Terminated Pre Enrollment Rapid Disenroll Cancelled A B Please Note This report will produce no more than 5000 records For Agent 1203 Application Tracking Number Internal Member ID Member Name ae oo DW SILS ok E kk se AR ae ook ok aE oo E ae ook SEEK oo ok EE nN ON N au ae ok ae Application Status CANCELLED nn A o 000000000 HRs ooo 1 Total for Report 11 Click on an underlined of Applications for Status total and a more detailed will be displayed The report below displays only the Active Applications for a particular agent For Agent 12 or Application Status ACTIVE mereeioto Thi
24. User Manual Click on the underlined Payment Summary by Agent link to view the Agent Summary report as shown below A E Payment Summary Agent Summary Summary of Agent Payments for voucher TN Selected Record Payee Id Payee Name A Process Month 04 Process Year 2012 Date Generated 0412 2012 Date Extracted to AP 04 12 2012 Reference Number i E Agent Writing anne Type Of Payment Amount Number Generated Hierarchy 7 394 57 Transaction History Id Record 291 72 Totals 7 676 29 Click on the underlined Payment Transaction Details link to view the Member Details report as shown below Payment Summary Member Details List of Transactions for Payment Voucher 1 Payee Id E Payee Name AA Process Month 04 Process Year 2012 Date Generated 04 12 2012 Date Extracted to AP 04 12 2012 Reference Number 1 Please Note This report will produce no more than 500 records Receiving Agent Writing Agent Application Tracking Internal Member ID Member Name Product Plan Name AWN Name AWN Name Number I B D ILS ILS ILS ILS ILS ILS ILS ILS Click on the underlined Payment Manual Adjustment Details to link to the Manual Adjustment Detail report as shown below CCP PERSONAL CARE PersonalCare Advantra Silver CCP PERSONAL CARE PersonalCare Advantra Silver CCP PERSONAL CARE PersonalCare Advantra Silver CCP PERSONAL CARE PersonalCare Advantra Silver CCP PERSONAL CARE PersonalCare Advantra Silver CCP PERSON
25. acker User Manual The report rows are categorized by y TAT Within 2 Days turn around time y TAT is More Than 2 Days turn around time y Total Applications By Turn Around Time Summary of Applications by Turn Around Time For Cont Market Rcvd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10012011 12 31 2012 TAT is More Than 2 Days TAT Within 2 Days O TAT Within 2 Days TAT is More Than 2 Days TAT Within 2 Days 470 TAT is More Than 2 Days 4 Total 433 Click on a colored section of the pie chart or an underlined Total number to view a more detailed report of the applications processed within the range chosen and their specific turn around time by number of days Applications Turn Around Time Detail of Applications by Turn Around Time For Cont Market Revd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 For Agent Please Note This report will produce no more than 5000 records Cont Market Current Home Off Application Tracking Dat TAT Calc Date Revd Dat Maar Member Name 12 16 2011 11 15 2011 12 16 2011 CCP GEORGIA 04 06 2012 03 22 2012 04 06 2012 m 032 MEDICARE PART D 12 15 2011 12 06 2011 12 15 2011 CCP GEORGIA 10 20 2011 10 17 2011 10 20 2011 D MEDICARE PART D Page 46 ACOM3 Application Tracker User Manual 2 17 Application Turn Around Time By Agent The Applications by Turn Around Time TAT report provides a summary of applications categor
26. an outstanding balance owed to Coventry The report will display information only for the payee An agent cannot generate a report for any payee other than their own The report will display the Payee Name Payee Number Negative Balance and the date of the Negative Balance origination cov ENTRY feotte face Welcome Negative Balance As of 04 30 2012 Payee Number Payee Balance Starting Date of Negative Status 04 26 2012 The report columns are categorized by y Payee Name y Payee Number y Payee Balance y Starting Date of Negative Status Users with a Payee that is not currently holding a negative balance will see the message No Negative Balance Data found for the specified date displayed on their screen when this report is chosen Note Contact the Broker Services Department to inquire about settling a negative balance Please see the Quick Reference Guide located at the end of this document for contact information Page 44 ACOM3 Application Tracker User Manual 2 16 Application Turn Around Time The Application Turn Around Time TAT report provides a summary of applications categorized by the period of time between Coventry s receipt of the member application and when that application is processed by the Coventry Enrollment Department The user may utilize four 4 data filters to seek application TAT information y From Cont Market Revd Date The system default date is 10 01 2011 To Cont Market Revd Date
27. be able to view their own contract details Page 23 ACOM3 Application Tracker User Manual dcov ENTRY Fendi fase Welcome Agent Roster As of 04 27 2012 PFFSMGA PFFSAG4 B LOA PFFSAG4 PFFSMGA Number of Agents For instance click on the blue colored portion of the pie chart to display a report of any Agent Level 4 agents assigned to the user who also have access to App Tracker The lower portion of the Agent Roster report lists the fields for Agent Level and Number of Agents Click on an underlined Agent Level field to produce an Agent Roster by Level detail report This second level of the Agent Roster report lists all agents of a specific contract level in the downline along with their recruiting agent information and the number of downline agents for each individual listed A a Agent Roster by Level As of 04 27 2012 For Level LOA VAAT Date Of Recruiting Agent Number of Birth Taxid SSN AWN Name Downline Agents 6 4 3 1 6 O RR ppppppop SS SS SS SS OOOO O oOo 0 FR a If an agent listed on this detail report has a downline click on the underlined AWN and that agent s downline details will be provided in a new report of the same format Page 24 ACOM3 Application Tracker User Manual 2 6 Agent Contract Status The Agent Contract Status report provides the agent user s contracting status and the contracting status of their downline agents if applicable The user may u
28. ck Here gt Get Started Using App Tracker App Tracker User Manual 13 MB Provider Listings Per State Click here to access our library of Recent Field Communications for Important news and notices TERMS OF USE PRIVACY POLICY Page 4 ACOM3 Application Tracker User Manual A Passo login Forgot Password a A AA 0 42 Once the user selects the link from the Broker Portal for App Tracker they will be transferred to the log in screen where the user will enter their User ID and Password Agent User ID The agent s AWN is their User ID Password The word Coventry and the last 4 digits of the user s Social Security Number Example Coventry1234 Admin User Note User is set up by agency request to allow Administrative Staff to view the status of enrollment applications and or commission information User ID Enter the User ID provided in advance from Coventry s Broker Services Department Password Enter the pre assigned Password also provided by the Broker Services Department First Time Users After initial log on users should follow the prompts that appear in the pop up box to reset their password to a secure personal password see below Tip Users should enter a password hint that will remind them of the password they selected Users are advised to keep their password in a secure location for future use Example An agent s password is Brandon51 and their hintis My son and his football numb
29. ck PSoft PSoft PSoft Check Entity Forward Payments Amount Type Number eel riage S 47170 FIRST HEALTH LIFE AND HEALTH Medicare 49 49 04 24 2012 4 Wieg Production Adjust nts 47170 FIRST HEALTH LIFE AND HEALTH Medicare 50 E PAID 04 10 2012 4 V Production Adjustment 47170 FIRST HEALTH LIFE AND HEALTH Medicare 5 5 47170 FIRST HEALTH LIFE AND HEALTH Medicare 701 15 716 47170 FIRST HEALTH LIFE AND HEALTH Medicare 47170 FIRST HEALTH LIFE AND HEALTH Medicare 102 00 749 647 20000 CHC OF GEORGIA HMO Medicare 86 86 20000 CHC OF GEORGIA HMO Medicare 35 35 20000 CHC OF GEORGIA HMO Medicare 37 E 37 20000 CHC OF GEORGIA HMO Medicare 50 50 PAID 12 07 2011 12 Wew Production Adiustmeng 47170 FIRST HEALTH LIFE AND HEALTH Medicare 10 10 PAID 11 30 2011 11 VieNProduction Adjustrofhts Medi PAID 11 21 2011 11 isa Production Adisftments Business Type As previously mentioned the View Statement Production and Adjustments fields shown above at the end of the Statement menu screen also generate reports Click on the underlined View Statement link and the PDF view of the commission statement is generated E i 46 F Ri Comment Sigt ho Medicare Payment Statement COVENTRY Health Core Medicare Commissions Reminder Terminated agents
30. cker is a key tool that assists our contracted selling partners and helps maximize efficient reporting for managing their Coventry book of business App Tracker gives you 24 7 access to information about contracting status as well as client s application status essential production and commission information This User Manual for the App Tracker provides step by step instruction for getting started We recommend that you first focus on the basics or most frequently accessed information such as the status of an application or commission payment status Once familiar with the general information and reporting App Tracker provides you ll want to check out the array of specialized reports that are available App Tracker is a dynamic time saver and provides information that our selling partners have indicated they rely on Brokers and agents can access up to date information on their contracting status as well as essential production enrollment and commission information Updated enrollment information is available approximately 3 5 days after submitting an enrollment application to Coveniry Your Agent Writing Number AWN is your User ID for the App Tracker and is used in conjunction with a password to access the system First time users enter a password that is indicated in this User Guide Once logged in first time users reset the password to create their own secure password Coventry s Application Tracking Number ATN on every submi
31. d State Effective Date Expiration Date Status 11 15 2007 06 28 2012 APPROVED 11 15 2007 03 31 2010 APPROVED Note If an agent s license is expired expiring an updated copy may be emailed or faxed to the Broker Services Department Please see the Quick Reference Guide located at the end of this document for contact information Page 26 ACOM3 Application Tracker User Manual CERTIFICATION The report below is generated from the View field in the Certification column Ran Type PRODUCT SPECIFIC TRAINING PRODUCT SPECIFIC TRAINING PRODUCT SPECIFIC TRAINING PRODUCT SPECIFIC TRAINING MEDICARE ATTESTATION MEDICARE ATTESTATION PRODUCT SPECIFIC TRAINING MEDICARE ATTESTATION MEDICARE ATTESTATION MEDICARE ATTESTATION Agent Contracting Status Listing of Certification on File in Payment System Product CCP GHP CCP GHP CCP PERSONAL CARE CCP PERSONAL CARE COORDINATED CARE PRODUCTS COORDINATED CARE PRODUCTS CCP PERSONAL CARE Coventry Core MEDICARE PART D MEDICARE PART D For AWN 160 yy Enrollment Start Date Enrollment End Date 01 01 2010 01 01 2011 01 01 2010 01 01 2011 01 01 2010 01 01 2011 01 01 2012 01 01 2012 01 01 2011 01 01 2012 12 31 2010 12 31 2011 12 31 2010 12 31 2011 12 31 2010 12 31 2011 12 31 2012 12 31 2012 12 31 2011 12 31 2012 Certification Date 10 12 2010 10 12 2010 10 12 2010 10 12 2010 10 12 2010 10 12 2010 09 04 2011 09 04 2011 09 04 2011 09 04 2011 E amp O T
32. e plan has been effective due to SNP INELIGIBLE MEMBER ineligibility or CMS term Contract or effective date assigned in error by Enrollment DISENR REQUESTED BY PLAN ACCEPTED BY CMS AS SUBMITTED Member requested disenrollment DISENROLLMENT BASED ON ENR IN ANOTHER PLAN Member enrolled in another plan ENR CANCELLED DISENROLLED PRIOR TO EFFECTIVE DATE Member cancelled prior to effective date AUTO TERM EVEN OCCURRED CAUSING MEMBER TO BE DISENROLLED Member deceased or lost A B eligibilit ENR REJECTED DUE TO BENEFICIARY BEING DECEASED Member is deceased BENEFICIARY DECEASED DOD ESTABLISHED Member is deceased VERIFICATION CALL TERM Member requested term during enrollment verification call Page 58 ACOM3 Application Tracker User Manual 5 2 Hold Forfeiture Reasons Certificate is not set up for the appropriate legal INVALID LEGAL ENTITY entity INVALID LICENSE Invalid or expired license INVALID PRODUCER Missing producer record in ACOM Missing invalid appointment at time of renewal INVALID RENEWAL APPOINTMENT commission payout Missing invalid attestation at time of renewal INVALID RENEWAL ATTESTATION commission payout Missing invalid license at time of renewal INVALID RENEWAL LICENSE commission payout MEDICARE ATTESTATION Missing incomplete attestation at the time of sale Missing attestation or attestation not complete at MEDICARE ATTESTATION FOR CCP the time of sale for an MA MAPD product Missing incomplete attesta
33. eady to Sell VIEW LOA Active 10 15 2011 VIEW VIEW PFFSMGA Active 10 15 2011 VIEW 10 15 2011 VIEW 10 15 2011 MISSING 09 21 20 10 15 2011 VIEW VIEW 09 17 20 MISSING NO MISSING 09 30 20 10 15 2011 NO MISSING 11 22 20 Click on any of the underlined VIEW fields in the Appointments Licenses E amp O or Certification columns and the sub reports for those fields will be generated APPOINTMENT The report below is generated from the View field in the Appointment column A E Agent Contracting Status Listing of Appointments on File in Payment System For AWN 1288 s Legal Entity Effective Date Expiration Date Status COVENTRY HEALTH AND LIFE INSURANCE COMPANY 12 24 2007 Active COVENTRY HEALTH AND LIFE INSURANCE COMPANY 12 24 2007 Active COVENTRY HEALTH AND LIFE INSURANCE COMPANY 03 12 2009 Active COVENTRY HEALTH CARE OF KANSAS 10 01 2010 Active FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY 10 07 2008 Active FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY 10 07 2008 Active FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY 03 12 2009 Active GROUP HEALTH PLAN INC 10 01 2010 Active GROUP HEALTH PLAN INC 10 01 2010 Active PERSONAL CARE INSURANCE OF ILLINOIS INC 10 01 2010 Active LICENSES The report below is generated from the View field in the Licenses column Agent Contracting Status Listing of Licenses on File in Payment System For AWN 11000 Ha License I
34. ed Terminated Rapid Disenroll Pre Enrollment Effective Date Date Policy Effective Expiration Date Date Policy Expired Termination Reason See 5 1 for Termination Reason Codes Writing AWN Agent Writing Number of Agent who wrote the application Writing Agent Name Name of Agent who wrote the application Date of Status Change Date a change was made within the member s policy Pend Reason Provided by Enrollment Current Home Off Revd Date Date application received by Enrollment Turn Around Time The amount of time between receipt of a member application to processing of the application by Enrollment ADD AAA AKAAKA MAMKA K lt Page 14 ACOM3 Application Tracker User Manual 2 2 Check for Application The Check for Application report provides the ability to check for the existence of an application submitted If the application does not exist the report will display with the message No Data Found If No Data Found appears when Check for Application is used and information for the application also does not appear via the Application Specifics report the application may not be assigned to the user s book of business Contact the Broker Services Department to inquire about a specific application Please see the Quick Reference Guide located at the end of this document for contact information The user must utilize at least one of three 3 data filters to retrieve results Application Tracking Number Assigned to t
35. een received with a specific Agent Writing Number attached and is being processed With this Application Tracking Number the application status can be conveniently tracked using App Tracker Page 56 ACOM3 Application Tracker User Manual 4 Agent Demographics Click on the tab labeled Demographics to access the correspondence address Coventry has on file for an agent or agency EE EE RT OEA Y 7 Peed te fos Welcome Statements Letters Demographics Addresses Address Type CORRESPONDENC Name Doe John o First Narne Middle Name Last Name or Agency Mame address 1 Address 2 Address 3 City Anytown o State Communication Preference Ema Contact Name Contact Phone PO Contact Fax PO Contact E Mail john doe gmail cam 63 Users should contact the Broker Services Department to make changes to their demographic information Please see the Quick Reference Guide located at the end of this document for contact information Page 57 ACOM3 Application Tracker User Manual 5 Report Detail References 5 1 Termination Reasons Termination Reason Code Reason Code Description MEMBER S REQUEST Member requested termination MOVED OUT OF SERVICE AREA Member moved out of the service area Termed for no Part A B no valid election period ESRD no SNP verification etc This can occur from a CMS rejection an original Coventry rejection prior to CMS submission a term after th
36. en selecting the Application information To Effective Date 12731 2012 3 The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the latest Enrollment Effective Date to consider vhen selecting the Application information Enter this field yn manuall Writing Agent Id y To limit the report to only member Applications associated to a specific Writing Agent AWN enter a specific AWD This is an optional parameter When specified the value must exactly match the Writing Agent assigned to the Application for the Applications to be selected Select item Application Status I lt _ from drop If you want the report limited to a specific Application Status select the appropriate status value Otherwise all status values will be included down menu Pre Enrollment Status Page 9 ACOM3 Application Tracker User Manual The following icons appear in the upper left hand corner of every report shown below y To export data to an EXCEL spreadsheet click on the icon y To export a report in a PDF format click on the a y To export a report in CSV format click on the icon When a pie chart graph is generated for a report users can eles on any portion of the chart to generate a corresponding report a z FAG Sf PEFSAG2 YA b a e LOA PESAGI S PEESAG2 O PEESAGS 0 PRAGA O PEESPIMOL PRESGA PEESAIGA Agent Roster
37. ent Statement COVENTRY Veaith Core Medicare Commissions Reminder Terminated agents will not receive renewal commissions a o_o INDIVIDUAL BUSINESS Product Contracts Amount First Year Overndes 1 Click to show one page ata time 206 Cobelo ekri 7 Be dill e gt 8 Be Comment _ 7 Be Jr Se 701 EA Comment _ Click to go to the next page in the document BBS Welle amp po EA Comment _ Click to go to the previous page in the document 7B el OU lors ole a Click to print this PDF file or pages from the file z Ble y 111 70 1 e A ez Comment Click to save this file to the user s computer or another location 7 E e dl 11 70 1 5 8 e Comment _ Page 52 ACOM3 Application Tracker User Manual BBE y fa 44 s 70 1 3 I z Comment Sign SN Medicare Payment Statement COVENTRY Heatith Core Medicare Commissions Reminder Terminated agents will not receive renewal commissions a meee SUMMARY INDIVIDUAL BUSINESS The icons located at the upper left hand side of the screen provide additional information and maneuvering L Go to specific pages using thumbnail images the results of the search J Search for items and see Page 53 ACOM3 Application Tracker User Manual Statement Production and Adjustments Reports FinanciallBalance Field Adjustments Adjustments or ment PaymentPSoft Che
38. er Page 5 ACOM3 Application Tracker User Manual 1 2 Log In Process The App Tracker log in screen will be presented when a user accesses the system via the Broker Portal a Forgot Password ACom3Cowentry 4 9 1 0 42 The user will enter their User ID and Password in the appropriate fields then click on the Log In button to access App Tracker For a forgotten password click the Forgot Password link that appears below the Log In button A box will appear with the hint that was created when resetting the user s password If the password will not reset due to a system error or other reason users should contact Coventry s Broker Services Department Please see the Quick Reference Guide located at the end of this document for contact information Page 6 ACOM3 Application Tracker User Manual 1 3 App Tracker Main Menu This is the Main Menu of the App Tracker system There are three tabs present on the screen y Reports Y Statements Letters y Demographics Click on each tab to navigate to the corresponding section of available data within App Tracker cov EM TRY Weoele Fay Welcome Application Specifics The Application Specifics report provides the ability to search for specific member Applications and The detail information includes Summary of Payments Transactional Payment Information by Agent From Cont Market Revd Date 1001 2011 ki This section was formerly tied From Application Da
39. er Member Name Product Plan Name State Effective Date Expiration Date Coverage Period Payment Hold Reason Sh Se Gh Gh Gh Gk Ge Gk Gk Gh Gk KX Page 38 ACOM3 Application Tracker User Manual 2 12 Forfeited Payments Summary The Forfeited Payments Summary report provides details on commissions that have been forfeited See 5 2 for Forfeiture Reasons The single required field for this report is the Report Grouping The system default for this field is Product but the report can also be grouped by Hold Reason See 5 2 for Hold Reasons or Agent Writing Number AWN gh Weleame E Reports App Specifics Check For Application n Apps By Status The first report in this senes will provide a summary of the payments forfeited The summar Apps By Agent By Status Agent Roster The summary report provides drill through capability to generate a report of the detail trans Agent Contract Status can be extracted in Excel extracted into a Comma Separated Value CSV file or the repor P ayments Summ ary Payments By Product Report Grouping Product Y Payments By Month f Indicate how you want the report data grouped for surmmnarization Held Payments Summary Held Payment Run Report The report columns are categorized by y Product First Year Payments Renewal Payments Manual Adjustments Total DE K XX XK Payments Forfeited Summary by PRODIJICT Manual Adjustments Total
40. feit Reason Forfeit From Date Forfeit To Date Please Note This report will produce no more than 500 records MEDICARE PART D 01 01 2011 MEDICARE PART D 01 01 2011 12 31 2011 MEDICARE PART D MEDICARE PART D 01 01 2011 01 01 2011 MEDICARE PART D 01 01 2011 MEDICARE PART D 01 01 2011 MEDICARE PART D MEDICARE PART D MEDICARE PART D ESTATION 01 01 2011 S 06 13 2011 TTESTATION 01 01 2011 06 09 2011 01 01 2011 12 31 2011 l 06 09 2011 MEDICARE PART D 01 01 2011 12 31 2011 888888888888 MEDICARE PART D 01 01 2011 12 31 2011 MEDICARE PART D 01 01 2011 12 31 2011 01 01 2011 12 31 2011 01 01 2011 12 31 2011 MISSING RENEWAL MEDICARE PART D MEDICARE PART D 88 On the report listing transactions forfeited the 15 data fields listed below will be present Receiving Agent AWN Receiving Agent Name Writing Agent AWN Writing Agent Name Application Tracking Number Member Name Product Plan Name State Effective Date Expiration Date Coverage Period Payment Forfeit Reason Forfeit Date Sh Gh Gh Ge Gh Gk Ge Gh US US US US MAM A Page 41 ACOM3 Application Tracker User Manual 2 14 Payment History By Member The Payment History by Member report allows the user to search within a combination of options to pull commission transaction information for each member The user can search for a broad range of members or for a specific member The user is able to obtain total commission summations for a u
41. for Hold Reasons or Agent Writing Number AWN eo WENTRY Mendaro Welcome Manager Administrator Broker Integration Credentialing Reports y Statemen Es Letters Demographics Reports App Specifics Held Payments Summary Apps By Status The first report in this series will provide a summary of the payments currently being held Apps By Agent By Status l l q Agent Roster The summary report provides drill through capability to generate a report of the detail tran Agent Contract Status can be extracted in Excel extracted into a Camma Separated Value CS file or the repi Payments Summary Payments By Product Report Grouping Product H ents Bw Payments By Month Indicate how you want the report data to be grouped for summarization Held Payment Details Run Report Clear Forfeited Payment Details Payment History By Membe App Turn Around Time On the Payments Being Held report the 7 data fields listed below will be present Product First Year Payments Renewal Payments Manual Adjustment Total IA US UA Payments Being Held gg A Summary by PRODUCT METE PRODUCT First Year Payments Renewal Payments Total Adjustments MEDICARE PART D 97 00 5 778 18 0 00 5 875 18 Part D Retail Sales Progra 1 690 00 0 00 0 00 1 690 00 1 787 00 5 778 18 0 00 7 565 18 Page 35 ACOM3 Application Tracker User Manual Click on an underlined Product link to generate a report of comm
42. he effective date Ne NEE UU The user may utilize six 6 filters to retrieve application status results y From Cont Market Revd Date The system default date is 10 01 2011 To Cont Market Revd Date The system default date is 10 14 2012 From Effective Date The system default date is 10 01 2011 To Effective Date The system default date is 12 31 2012 Product Drop down menu allows user to select a single unique Product State Drop down menu allows user to select a single unique State NADA Gco VENTRY Prodi Tage Welcome Applications By Status Utilize these reports to view Applications grouped by Application Status From Cont Market Revd Date 1001 2011 k This section was formerly tied From Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the earliest Application Receive Date to consider when selecting the Application information To Cont Market Ecvd Date 10 14 2012 tj This section was formerly tited To Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the latest Application Receive Date to consider when selecting Application information From Effective Date 1o 01 2011 kj Filters applications where the Effective Date is on or after the specified date To Effective Date 12 31 2012 k Filters applications where the Effective Date is on or before the
43. he member upon receipt of their enrollment application y HICN Member s Medicare ID number y Member Name Full or partial name search is available These fields are not case sensitive but the spelling must match identically to the information in the Coventry enrollment system to successfully retrieve the member information Ass YENTRY Frodl a Face Welcome This report provides the ability to check for the existence of an Application and if that Appli If the Application does not exist the report will display with no data found If the Application does exist but is assigned to the HOUSE agent the member s name will dis If the Application does exist and is not assigned to the HOUSE account the member s name get detail information on the Application Enter a specific Application Tracking Number to check the database for its existence The value specific must exactly match the ATH in the database Member Name SS Enter 4 specific Member Name in the format indicated below ta check the database for its existence The valve specific must exactly match the Member Name in the database Example Last First MIJ Enter a specific HICH to check the database for its existence The value specific must exactly match the HIH in the database Run Report Clear Page 15 ACOM3 Application Tracker User Manual Below is an example of the Check for Application report as it will appear on the App Tracker screen after search criteria has been cho
44. he report below is generated from the View field in the E amp O column Agent Contracting Status Listing of E amp O Insurance on File in Payment System For AWN 1600 5 Insurance Id Status Days Till Termination of Contract Effective Date 08 01 2010 Expiration Date Insurance Name 08 01 2012 Aspen Specialty Insurance Company The report below is generated from the Expired field in the E amp O column Agent Contracting Status Listing of E O Insurance on File in Payment System For AWN 160 go Insurance Id Status Days Till Termination of Contract Effective Date 04 23 2010 Expiration Date Insurance Name 04 23 2011 Westport Insurance Company Due For Termination Page 27 ACOM3 Application Tracker User Manual 2 7 Payments Summary The Payments Summary report provides a list of the payment summaries statements in order of most to least current Each payment summary can be selected to obtain detailed information on the transactions and manual adjustments that comprise that payment summary The user may utilize three 3 filters to retrieve payment summary information y Starting Date Agent Writing Number Y Payee ID AWN of the payee account y Financial Entity CoventryOne Medicare The Starting Date is the only required field and the system default is the date one year prior to the current date Note Payment summaries will only generate for agents whose commissions are paid to themselves same SSN
45. ilico aa aa ae as 39 2 13 Forfeited Payment Details iaa 40 2 14 Payment History By MCMDEL 1ccccccccseccseecsuecseecsuecsuessuessaeessueesuessuessanessnessuessuesseesnessnesanes 42 2 15 Negative DANCE S A II IEA 44 2 16 Application Turn Around TIME ccsccccccseccseccuecsuecsuecuessuessueseessuessueseessuessuensusauessusseesauesanssensanenas 45 2 17 Application Turn Around Time By Agent ccccccscceecseecnecceessuessueceesauessuensessuessueseessuessnssensanenas 47 3 Statements amp Letters sosionom aaa aaa Aaaa EAA AAKE AAE Aa AE AANA 49 eV O OON S E E SS 49 Ni A A 56 A AJEN Demos aphlCS no 57 5 Report Detall REOTerences muscuntrsoincaca ai iiniciis dial iiietie tacita 58 I LCNMINAUON TACASONS seirinin rnanan e aA AEEA enano abrio ria nanana 58 5 2 Hold Forfeiture Reasons ccscccscccseecceeccseecsuessueessnessuessueesueesaeesauessueeseeesanesseessuessuessanesanessuessnseans 59 6 Contacting the Broker Services Department cccceececeseeceneeceseeceneeeenenceneseseeeeneseeneseeneseenenes 60 Page 2 ACOM3 Application Tracker User Manual 1 Welcome to Application Tracker Coventry Health Care Inc continues to lead in providing valuable benefits focused Medicare Advantage and Part D Prescription Drug products Our brokers and agents are dedicated to assisting beneficiaries in making the right health care choices for their individual needs Coventry s robust online Application Tracking System App Tra
46. in the chart Active Terminated Pre Enrollment Rapid Disenroll Cancelled y Total for Product State y TAT Within 2 Days turn around time y TAT is More Than 2 Days turn around time Any field that is underlined on the report screen represents the ability to drill down to more detailed data In this example click on the number for the amount of Total for PARTD applications 1479 under the status of Active and a more detailed report will be generated Applications By Stat List of Applications for specific Application Sta For Cont Market Revd Dates Within 10 01 20 For Effective Dates Within 10 01 2011 or Application Status ACTI pacetote This rep dnd Tracking A el Product Plan Name eee47 A MEDICARE PART D Retail Sales Program Robe O1A MEDICARE PART D Retail Sales Program e 1628 MEDICARE PART D FH Premier FEEEEEO4JA MEDICARE PART D FH Premier FERREE 7G4D MEDICARE PART D FH Premier eeeEOTSA MEDICARE PART D PREMIER_PLUS eeerHOGEA MEDICARE PART D FH Premier eeeO778 MEDICARE PART D FH Premier 445318 MEDICARE PART D FH Premier Writing Writing Agent Name Agent AWN A A A A A A A A A Page 18 ACOM3 Application Tracker User Manual The rows are first categorized by Product then by State Each Product category will have a row to represent the summary total of each state represented The final row shows the overall summary of membership labeled Total by Status Each value in this row will show the To
47. ing information available v Producer AWN Agent Writing Number v Producer Name v Name of Coventry Health Plan you are contracted with or your Distribution Partner or upline lf you contact the BSD to inquires about an enrollment application submitted to Coventry or to inquire on a commission payment please be prepared to provide the following information Member or applicant full name Member or applicant Medicare ID Number Member or applicant DOB Member or applicant Address lt lt cc Coventry policies and procedures safeguard our members personal health information and prohibit release of any benefits claims or demographic information related to our members Thank you for your partnership and service to our members Page 60
48. issions that have been held for that product including the hold reason see 5 2 for Hold Reasons E Payments Held Listing of Transactions that have been Held For PRODUCT MEDICARE PART D Please Note This report will produce no more than 500 records Receiving Agent Writing Agent Application Tracking Effective Expiration Coverage Number Date Date Month Year MEDICARE PART D i 01 01 2011 12 31 2011 7 00 MEDICARE HIERARCHY ATTESTATION Member Name Product Plan Name State Payment Hold Reason MEDICARE PART D 05 01 2012 4 00 INVALID LICENSE MEDICARE PART D i 01 01 2011 0 16 MEDICARE ATTESTATION MEDICARE PART D i 01 01 2011 0 16 MEDICARE ATTESTATION MEDICARE PART D i 02 01 2011 12 31 2011 4 00 MEDICARE HIERARCHY ATTESTATION MEDICARE PART D i 02 01 2011 12 31 2011 3 00 MEDICARE HIERARCHY ATTESTAT MEDICARE PART D 07 01 2011 4 00 MEDICARE ATTESTAT MEDICARE PART D i 07 01 2011 4 00 MEDICARE HIERARCHY ATTESTATION ION HIERARCHY ION On the report listing payments held for a particular product the 15 data fields listed below will be present Receiving AWN Agent Name Writing Agent AWN Writing Agent Name Application Tracking Number Member Name Product Plan Name State Effective Date Expiration Date Coverage Month Coverage Year Payment Hold Reason Sh Se Gh Gh Gh Gh Ge Gh Gh Gh Gk US UU Page 36 ACOM3 Application Tracker User Manual 2 11 Held Payment Details The Held Payment Detail report p
49. ized by Writing Agent and listing the period of time between Coventry s receipt of the member application and when that application is processed by the Coventry Enrollment Department The user may utilize four 4 data filters to seek application TAT information y From Cont Market Revd Date The system default date is 10 01 2011 y To Cont Market Revd Date The system default date is 10 14 2012 y From Effective Date The system default date is 10 01 2011 y To Effective Date The system default date is 12 31 2012 This report also provides the ability to prioritize the sequence of the report by the use of a Sort Order The options listed below appear in the drop down menu for the sort y Writing Agent ID system default y Writing Agent Name Ben w ERTEY frolli Tarr Welcome summary of Applications by Agent by Turn Around Time From Cont Market Revd Date 1001 2011 43 This section was formerly tiled From Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the earliest Application Receive Date to consider when selecting the Application information To Cont Market Revd Date 10 14 2012 52 This section was formerly tiled To Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the latest Application Receive Date to consider when selecting the Application information
50. l be included Pre Enrollment Status Page 7 ACOM3 Application Tracker User Manual 1 4 Basic Navigation In the upper right hand corner of every App Tracker screen menu there are three icons These cons are shortcuts for various actions Addresses Address Type CORRESPONDENC y Name DS E Update User Profile A Help User Guide e Help F Log Cut p ooo ooo coe Log Out Version 4 When selecting the Update User Profile icon the following screen will appear User Profile Mare Contact Email Contact Phone Contact Fax Change Password Enter the following information y Contact Email User s email address Contact Phone The phone number used to contact the user during business hours Contact Fax User s Fax number Change Password Allows the user to update or change their Application Tracker e mail address NDS Selecting the Help User Guide icon will open a link to this User Manual gt ACom3Coventry Broker Windows Internet Explorer COVENTRY j Health ore User Documentation AppTracker User Guide Page 8 ACOM3 Application Tracker User Manual As users navigate the various screens throughout App Tracker they will notice the following consistent options y Run Report y Clear At the bottom of each main report menu are the Run Report and Clear actions Click on elther to generate the report or to clear fields that may have been entered Run Report
51. lecting that Hold Reason value Primary Sort Order Receiving Agent Mame Y Select the primary field for which the Held Transaction information should be ordered Secondary Sort Order writing Agent Name Y Select the secondary field for which the Held Transaction information should be ordered Run Report Clear Page 37 ACOM3 Application Tracker User Manual Held Payment Details Listing of Transactions Currently Held Member Name Product Plan Name Effective Expiration Coverage Payment Hold Reason Date Date Period MEDICARE PART D FH Premier 01 01 2011 08 2011 MISSING RENEWAL ATTESTATION MEDICARE PART D FH Premier 01 01 2011 09 2011 E a a TATION MEDICARE PART D FH Premier 01 01 2011 10 2011 2 50 MISSING RENEWAL ATTESTATION MEDICARE PART D FH Premier 01 01 2011 11 2011 2 50 MISSING RENEWAL ATTESTATION MEDICARE PART D FH Premier 01 01 2011 12 2011 2 50 MISSING RENEWAL ATTESTATION MEDICARE PART D FH Premier 01 01 2011 01 2012 2 50 MISSING RENEWAL ATTESTATION MEDICARE PART D FH Premier 01 01 2011 02 2012 2 50 MISSING RENEWAL ATTESTATION MEDICARE PART D FH Premier 01 01 2011 03 2012 2 50 MISSING RENEWAL ATTESTATION MEDICARE PART D FH Premier 01 01 2011 04 2012 2 50 MISSING RENEWAL ATTESTATION 22 50 On the report listing payments held for a particular product the 14 data fields listed below will be present Receiving Agent AWN Receiving Agent Name Writing Agent AWN Writing Agent Name Application Tracking Numb
52. nique member If multiple transactions exist The user may utilize six 6 filters to seek payment history information From Effective Date The system default date is 10 01 2011 To Effective Date The system default date is 10 14 2012 HICN Allows entry of a unique member HICN Medicare ID Member ID Allows entry of a unique member policy ID Product Drop down menu allows a user to select a single Product Member Name Allows entry of a full or partial name lt A AO den YVENTRY Fradia fase Welcome From Effective Date 10012041 53 The Policy information selected can be limited based on the Policy Effective Date This parameter dictates the earliest Policy Effective Date to consider when selecting the Policy information To Effective Date 10 14 2012 53 The Policy information selected can be limited based on the Policy Effective Date This parameter dictates the latest Policy Effective Date to consider when selecting the Policy information To limit the report to the policies associated to a specific HICH enter that specific HICH This is an optional parameter When a value is specified the value must exactly match the HICN for the Policies to be selected Member ID INN To limit the report to the Policies associated to a specific MemberID enter that specific member s Name This is an optional parameter When a value is specified the value must exactly match the MemberID for the Policy to be selected Product Y
53. ns The detail information i wie of Payments Transactional Payment Information by 4 Report Options From Cont Marka This section was formerly UB we Date The Application information selected can be limited based on the Application Receive Date This pararneter dictates the earliest Application Receive Date to consider when selecting the Application information To Cont Market Revd Date 10 14 2012 3 This section was formerly tied To Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the latest Application Receive Date to consider when selecting the Application information From Effective Date 10 01 2011 43 The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the earliest Enrollment Effective Date to consider when selecting the Application Note Users will only be able to obtain data for membership effective 01 01 2009 and forward Anything earlier is not viewable with this application Page 11 ACOM3 Application Tracker User Manual 2 1 Application Specifics The Application Specifics App Specifics report provides the ability to search for a single member application or multiple member enrollment applications and supporting detail according to what is specified for that particular member application While Application Specifics options include commission Paymen
54. nts related to each Product From Date 1001 2011 E Reporting will include only those payments made within the From and To Date selections To Date 12 31 2012 ki Reporting will include only those payments made within the From and To Date selections Run Report Clear The report rows are categorized by Product and Totals of each column on the bottom The report columns are categorized by y Product First Year Payments Renewal Payments Manual Adjustments Total K XX XK 5 Payments Summary by Product For Date Periods 10 01 2011 to 12 31 2012 7000 6000 5000 E 4000 E E 3000 2000 1000 0 C AAA MAHPA PARTD Product E First Year Payments Renewal Payments Manual Adjustments Product First Year Payments Renewal Payments Manual Adjustments Total CCP GEORGIA 386 00 88 37 15 00 489 37 CCP HEALTHAMERICA and HEALTHASSURANCE 5 88 5 88 MEDICARE PART D 384 02 4 794 93 231 00 5 409 95 Part D Retail Sales Program 6 681 00 6 681 00 Totals 7 451 02 4 889 18 246 00 12 586 20 Page 31 ACOM3 Application Tracker User Manual The report also provides access to additional details on manual adjustments related to each product Click on any of the underlined totals in the Manual Adjustments column of the Payments Summary by Product report and the Manual Adjustment Summary data will be generated Payments Summary by Product Manual Adjustment Summary For Date
55. ppear on the App Tracker screen after search criteria has been chosen and the report has been run The reports generated are larger than the screen so the user will need to scroll to the right to see all fields and data a Y 3 Applicatid For Cont Market Revd Dates For Effective Dates Within Please Note This report will produce no more than 5000 records Application Tracking Number DP Internal Member ID Member Name Product Plan Name State ETN iona MPD A Part D Retail Sales Program Retail Sales Program NH 11 08 20 Part D Retail Sales Program Retail Sales Program 11 11 20 MEDICARE PART D FH Premi 04 27 20 Part D Retail Sales Program Retail Sales Program 11 02 20 Part D Retail Sales Program Retail Sales Program 11 22 20 MEDICARE PART D FH P 11 23 20 A A A A Part D Retail Sales Program Retail Sales Program 11 22 20 A A A Part D Retail Sales Program Retail Sales Program 11 17 20 On the Application Specifics report the 18 data fields listed below will be present Application Tracking Number Assigned to the member upon receipt of their enrollment application Internal Member ID Internal Coventry ID number Member Name Full name of member HICN Health Insurance Claim Number Medicare ID Number Product Part D or MA MAPD Product name Plan Name Plan name under which the Product is marketed State Resident state of member Cont Market Revd Date Date application received by Enrollment Application Status Active Cancell
56. r Year 2012 First Year Payments Renewal Payments 700 600 500 400 E 2 300 200 100 0 Feb Month Month Manual Adjustments Monthly Total 7000 6000 5000 E 4000 4 3000 2000 1000 0 Month Month First Year Payments Renewal Payments Monthly Totals January 127 22 626 47 3 E 953 69 February 28 22 624 56 652 78 March 78 88 679 39 i 804 27 April 6 742 28 703 26 i 7 445 54 Totals 6 976 60 2 633 68 5210 08 9 856 28 Click on any of the underlined totals in the Manual Adjustments column of the Payment Summary by Month report to access Manual Adjustment Summary details Payments Summary by Month Manual Adjustment Summary For 03 2012 Adjustment Description AWN Agent Name Product Month Adjustment Amount Reverse charge backs mo a MEDICARE PART D Reverse charge backs on 1 CCP GEORGIA Total On the Payments Summary by Month Manual Adjustment Summary report the 7 data fields listed below will be present Adjustment Description AWN Agent Name Product Year Month Adjustment Amount NESSES SE Page 34 ACOM3 Application Tracker User Manual 2 10 Held Payments Summary The Held Payments Summary report will provide a summary of commissions currently being held by Coventry The single required field for this report is the Report Grouping The system default for this field is Product but the report can also be grouped by Hold Reason See 5 2
57. re Advantra Silver PersonalCare Advantra Silver Retail Sales Program PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver report Page 22 ACOM3 Application Tracker User Manual 2 5 Agent Roster The Agent Roster report provides information regarding the agent hierarchy and downline of the user or of the agent s assigned to the user The single required field for the Agent Roster report is the As of Date The system default is the current day deso VEM TRY r roda Saro Welcome These reports provide information regarding the Agents in the hierarchy The initial report provides a summary of the agent counts by Hierarchy Level From there you can drill into the details of the agents comprising each Hierarchy Level Once a specific agent is selected you can view a report of the reporting structure under that agent AsOfDate 04 27 2012 k Run Report The initial level of Agent Roster report is a Summary of hierarchy and downline for the agent user The report is interactive which means the user can click on any part of the graph to generate a more detailed report of what that portion of the graph represents Note If auser does not have any Coventry contracted agents in their downline they will only
58. rovides the details on commissions currently being held The user may utilize four 4 filters to retrieve payment summary information Receiving Agent AWN y Writing Agent AWN y Product y Hold Reason See 5 2 for Hold Reasons This report also provides the ability to prioritize the sequence of the report by the use of a Primary Sort Order and Secondary Sort Order The options listed below appear in the drop down menu for each sort Receiving Agent Name Primary Sort system default Receiving Agent AWN Writing Agent Name Secondary Sort system default Writing Agent AWN Product Hold Reason NDA DS Leo YEW TRY r Frollo Face Welcome Provides a detail report listing of the Transactions currently being held The listing can be limited the Primary and Secondary Sart parameters The report content can be limited to data associated to a specific Receiving Agent s AWM by specifying that AWM value When specified this value must exactly match the Receiving Agent AWN on the held transactions The report content can be limited to data associated to a specific Writing Agent s AWM by specifying that AWM value When specified this value must exactly match the Writing Agent AWM on the held transactions Product Y The report content can be limited to data associated to a specific Product by selecting that Product value Hold Reason Y The report content can be limited to data associated to a specific Hold Reason by se
59. s listed below appear in the drop down menu for each sort Receiving Agent Name Primary Sort system default Receiving Agent AWN Writing Agent Name Secondary Sort system default Writing Agent AWN Product Forfeit Reason DDD Lee WENTRY Peoetlib Fago Welcome The first report in this series will provide a summary of the payments forfeited The summary The summary report provides drill through capability to generate a report of the detail transad can be extracted in Excel extracted into a Comma Separated Value 0544 file or the report The report content can be limited to data associated to a specific Receiving Agent s AWN by specifying that AWM value When specified this value must exactly match the Receiving Agent AWN on the forfeited transactions The report content can be limited to data associated to a specific Writing Agent s AWN by specifying that AWN value When specified this value must exactly match the Writing Agent AWN on the forfeited transactions Product The report content can be limited to data associated to a specific Product by selecting that Product value Forfeit Reason The report content can be limited to data associated to a specific Forfeit Reason by selecting that Forfeit Reason value Page 40 ACOM3 Application Tracker User Manual Forfeited Payment Details Listing of Transactions Forfeited For Report Selections Receiving Agent AWN ai Writing Agent AWN Product PARTD For
60. s re ort will produce nosseerethian 5000 records Application Tracking Number Internal MemberID Member Name Product Applications By Agent By Status Listing of all Applications grouped by Agent by Application Status For Cont Market Revd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 CCP PERSONAL CARE Part D Retail Sales Program MEDICARE PART D CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE HORDAS A ARONA RARA AA He ER RO OSE AROS A HHEKKAKQED A Hk RAK OP AERO A HAE RIES A He kI A ARONA A ROA 10 Applications By Agent By Status List of Applications by Agent by Application Status For Cont Market Revd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 Product CCP PERSONAL CARE CCP PERSONAL CARE Part D Retail Sales Program CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE CCP PERSONAL CARE Plan Name PersonalCare Advantra Silver Retail Sales Program FH Premier PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver PersonalCare Advantra Silver Plan Name PersonalCa
61. sen and the report has been run co VENTRY Feot face Welcome Check for Application Member Name Message Member ATN exists If not displayed on your amp ATN is not assigned to your book of business Member ATN exists If not displayed on your amp ATN is not assigned to your book of business Member ATN exists If not displayed on your A ATN is not assigned to your book of business Member ATN exists If not displayed on your A ATN is not assigned to your book of business ee UE D Fi Member ATN exists If not displayed on your A ATN is not assigned to your book of business On the Check for Application report the four 4 data fields listed below will be present Application Tracking Number Assigned to member upon receipt of enrollment application Member Name Full name of member HICN Health Insurance Claim Number Medicare ID Number Message Member ATN exists If not displayed on your Application Specifics report the ATN is not assigned to your book of business lt i K lt Page 16 ACOM3 Application Tracker User Manual 2 3 Applications by Status The Applications by Status report provides the ability to view Applications grouped by their current Application Status Active Policy is effective Terminated Policy is terminated Cancelled Policy is cancelled prior to the effective date Pre Enrollment Policy status prior to enrollment Rapid Disenrollment Policy terminated within 3 months of t
62. ser Manual 3 2 Letter History Click on the tab labeled Statements Letters and choose Letter History from the left hand side of the screen to access letters sent by the Broker Services Department There are 4 columns in the Letter History listing y Letter No Type of Letter y Date Generated Date Letter Sent y Time Generated Time Sent y View click on View to open a PDF version of a letter in a new window The following is a description of the letters stored in App Tracker y Request for Information RFI Letter Notification that a member the agent enrolled has received a Request for Information Letter in order to complete processing of application Missing information MUST be received within the specified timeframe to avoid the application from being denied y NotReadyToSell An application for membership has been received with a specific Agent Writing Number but our system indicates that the agent s Coventry Contracting Certification is NOT complete in order to receive commissions y License Expiring Expired The State License s on file is about to expire or has expired In order to receive commissions on application written in that State s we must have an active license y E amp O Expiring Expired The Errors and Omissions Insurance on record for an agent is expiring or has expired An updated policy must be received by the Broker Services Department y ATNAppTracker An application for membership has b
63. tal by Status for each of the five 5 enrollment categories and match the numerical value on the pie chart Among the columns showing in the first example on the previous page the field Pre Enrollment is underlined Click on this status to open a new pie chart report for all Applications under the Pre Enrollment status These applications are now subdivided into two new categories y In Process Applications are in process for pre enrollment y Pending Applications are pending approval for enrollment Applications By Status Summary of Applications in Pre Enrollment by Status For Application Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 IN PROCESS 36 B IN PROCESS Pre Enrollment Status Number of Applications for Status 36 36 Applications By Status List of Applications for specific Pre Enrollme For Application Dates Within 11 15 2007 1 For Effective Dates Within 01 01 2008 12 Application Tracking Member Name Product State Application Date 12 08 2007 12 12 2007 12 02 2007 12 03 2007 Page 19 ACOM3 Application Tracker User Manual PARTD NY 1479 1679 Total for PARTD 1479 1680 1679 Total by Status 1479 36 1680 1679 PRE RAPID Total for TAT Within TAT is More ACTIVE CANCELLED ENROLLMENT DISENROLL TERMINATED Product State Than 2 Days 163 36 1 1680 1 36 The figures displayed in each column for each Total row in the lower half of the Application
64. te The Application information selected can be limited based on the Application Receive Date This parameter dictates the earliest Application Receive Date to consider when selecting the Application information To Cont Market Revd Date 10 14 2012 kii This section was formerly tiled To Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the latest Application Receive Date to consider when selecting the Application information From Effective Date 10 01 2011 kti The Application information selected can be limited based on the member s Enrollment Effective Date This parameter dictates the earliest Enrollment Effective Date to consider when selecting the Application information To Effective Date 12731 2012 8 The Application information selected can be limited based on the member s Enrallment Effective Date This parameter dictates the latest Enrollment Effective Date to consider vhen selecting the Application information To limit the report to only member Applications associated to a specific Writing Agent AWN enter a specific AWD This is an optional parameter When specified the value must exactly match the Writing Agent assigned to the Application for the Applications to be selected Application Status If you want the report limited to a specific Application Status select the appropriate status value Otherwise all status values wil
65. these reports to view Applications grouped by Writing Agent and Application Status From Cont Market Revd Date 1001 2011 Pa This section was formerly tited From Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the earliest Application Receive Date to consider when selecting the Application information To Cont Market Revd Date 10 14 2012 3 This section was formerly tied To Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the latest Application Receive Date to consider when selecting the Application information Effective Date From 10 01 2011 kt Filters applications where the Effective Date is on or after the specified date Effective Date To 12 31 2012 k Filters applications where the Effective Date is on or before the specified date Sort Order writing Agent Name Select the order in which you want the data to be sorted Run Report Clear a la Applications By Agent By Status Summary of Applications by Agent by Application Status For Cont Market Revd Dates Within 10 01 2011 10 14 2012 For Effective Dates Within 10 01 2011 12 31 2012 a Agent of Writing Nave Agent Level application Status aplications for TANT Within 2 Days TAT is More Than 2 Days Sta Number LOA7 gt A u LOA CANCELLED LOA ACTIVE LOA ACTIVE LOA CANCELLED
66. tilize eleven 11 filters to retrieve contract status information y AWN Agent Writing Number Agent Name Full or partial name may be searched Agent Status Active Terminated Rejected Deceased Non Marketable Ready to Sell Yes No Certification Yes Missing Contract Received Date Yes Missing W9 Date Yes Missing Background Passed Adverse Failed Missing License Yes Missing Appointment Yes Missing ESO Insurance Yes Missing Expired NADA ADD DADAS The only required field is As of Date The system default is the current date If no specific Agent Writing Number and or no specific Agent Name is entered the report will display information for all agents associated with the user AWN or Admin User ID The results may also be sorted by either Broker ID or Broker Name Be OYE TRY Profile Faro Welcome Statements Lette rs App Specifics Check For Application Apps By Status Apps By agent By Status Agent Raster Agent Contract Status Payments Summary Payments By Product Payments By Month Held Payments Summary Held Payment Details Forfeited Payments Summa Forfeited Payment Details Payment History By Membe Negative Balances app Turn Around Time App Turn Around Time By Demographics il Agent Contract Status Provides a listing of the Agents along with the current contracting status Also provides Payment System MOTE Search fields are not case specific As Of Date 04 30 2
67. tion at the time of sale MEDICARE HIERARCHY ATTESTATION to qualify for override commission Manual HOLDS Compliance Miscellaneous MISCELLANEOUS Holds MISSING BROKER DETAIL Missing invalid detail screen for product sold Missing invalid attestation at time of renewal MISSING RENEWAL ATTESTATION commission payout ee crecio ON MCR EXCLUSION LIST list oa O call PDP REFERRAL contract Part D Retail Sales policy was terminated within PDPRSP RAPID DISENROLLMENT 90 days of the effective date Part D Retail Sales policy has not been effective PDPRSP VERIFICATION for a minimum of 90 days Medicare Exclusion lists are being checked to PENDING MCR EXCLUSION LIST determine if Writing Agent is listed TERMED BROKER Agent was terminated at the time of sale Sale made during time period of a Voluntary VOLUNTARY MARKETING FREEZE Marketing Freeze being in place Page 59 ACOM3 Application Tracker User Manual 6 Contacting the Broker Services Department BSD A Quick Reference Guide for contacting the BSD with your App Tracker related questions Hours of Operation B 8am 6pm EST Monday Friday Phone 1 866 714 9301 toll free Fax 1 724 741 7285 Email brokersupport cvty com B List the nature of the issue in the subject line B Responses from the BSD will be reviewed within 48 to 72 hours Broker Portal broker cvty com When contacting the BSD by phone in order to expedite your call please remember to have the follow
68. ts Summary by agent and by date use of the Payments Summary feature is not accessible based on a user s App Tracker privacy and security status for use of App Tracker as described on page 11 The user may utilize ten 10 data filters to seek application specific details From Cont Market Revd Date The system default date is 10 01 2011 To Cont Market Revd Date The system default date is 10 14 2012 From Effective Date The system default date is 10 01 2011 To Effective Date The system default date is 12 31 2012 Writing Agent ID Agent Writing Number Application Status Drop down menu allows selection of a single status Pre Enrollment Status Drop down menu allows selection of a single status Application Tracking Number Assigned to the member upon receipt of their enrollment application HICN Member s Medicare ID number Member Name Full or partial name search is available KI KAKI NESE den VENTRY Froli Farce Welcome The Application Specifics report provides the ability to search for specific member Application The detail information includes Summary of Payments Transactional Payment Information by From Cont Market Revd Date 10 01 2011 kti This section was formerly tied From Application Date The Application information selected can be limited based on the Application Receive Date This parameter dictates the earliest Application Receive Date to consider when selecting the Application information To Cont Market
69. tted new enrollment application is the data you enter to access the status of client applications through our system as well as the commission payments by Coventry We wish you complete success in serving the needs of Medicare beneficiaries Page 3 ACOM3 Application Tracker User Manual 1 1 Initial Log In for First Time User The App Tracker System is accessible through the Coventry Broker Portal To access the Broker Portal go to broker cvty com Once a user has logged in to the Broker Portal the link to select is located on the Broker Portal Home Page under the section for App Tracker or on the App Tracker landing page upon selection of the App Tracker link from the header section of any page within the Broker Portal Look for the Click Here link CONTACT US SITE MAP WWelcome to irst Health Part O Broker Portal designed to help you be successful in selling our Medicare products You can complete the online training Update your profile view and order collateral and marketing materials and access additional broker tools by selecting the appropriate link in the left navigation Additional links and resources can also be found below Agent Contracting NOMOREFORMS POP Referral Contracting NoMoreForms An Agent s Guide to Submit an Electronic Contract v a nomoreforms App Tracker App Tracker is an easy to use online tool for you to check application status review your commissions payments run reports and mor Cli

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