PEP-ing Enrollment Form

In the Search Criteria, AAR's will enter the member's ________ before clicking "Search Core"

• MRN Prefix, MRN, First Name, Last Name, and Date of Birth

• Region, MRN Prefix, MRN, Last Name, and Date of Birth

• Region, Full Name, and Date of Birth

• Region, MRN Prefix, MRN, First Name, and Last Name

If the member's DOB or MBI are incorrect in PEP, you will need to change them in the PEP User Inputs column and check ___.

• the Bypass BEQ Resubmit check box.

• the Downgrade Box

• the Expedite Box

• the Medicaid Box

If you need to create a MRN for the member, click ___.

If an individual form is marked with the SNP plan option or the member indicated they have Medicaid, ____.

• click App Data Entry Completed.

• click the Dual Eligible button.

• complete the enrollment.

• route to RFI Team.

If the address can not be validated, attempt to validate the address by______ and _______.

• calling and e-mailing the member.

• phone and other sources.

• Google and USPS Tool.

• calling and texting the member.

If there are duplicate bands for the member with identical MRNs and no separate coverage, you will use the ____ band.