NUZ Alerts
Beginning January 1, 2025 the BlueCross and BlueShield Association retired the Member Touchpoint Measures (MTM) program and replaced it with this.
What is the Local Operations Scorecard (LOS)?
This is how frequently you should check in with you caller while they are on hold during research.
What is every 2 minutes?
Long before creating Mario or the Game boy, this famous video game giant was founded in Japan in 1889 as a playing card company.
What is Nintendo?
These are the two primary methods for contacting another BCBS Plan.
What are a General Inquiry (GI) via Blue2 and a Plan to Plan (P2P) phone call?
This federal act dictates what type of outreach is appropriate when calling a number known to be a cell phone.
What is the Telephone Consumer Protection Act (TCPA)?
To create a smoother call experience, Member Customer Service combined the Preauth Verification template with this other specific template.
What is the Benefit Quoting Template?
It is recommended that Customer Service Professionals use this AI-powered tool to ask benefit questions before turning to the benefit booklet.
What is the Virtual Assistant?
Thanks to its low moisture and natural acidity, this sweet edible substance produced by insects is the only natural food that never spoils.
What is honey?
This program revolutionizes how Regence supports members with complex health needs through personalized care and meaningful connections across the healthcare system.
What is PIC?
This type of information can be shared with a caller without verifying their identity.
What is general benefit information (shared by all members of a Group)?
If a member goes to an in-network provider office visit and gets billed by an out-of-network laboratory, no adjustment is warranted because the member is encouraged to verify this before their appointment.
What is the provider's choice of laboratories?
Regardless of whether PHI was obtained or released, a task must be created anytime this occurs during a call.
What is the exchange of information?
Despite living in the ocean, these social marine mammals give each other unique vocal whistles that act just like human individual names.
What are dolphins?
Following the Peer to Peer process change, staff should lean into this resource for the status of peer to peers.
What is CCA?
This age is considered the reasonable threshold at which a minor is old enough to understand and sign their own Disclosure Authorization.
What is 13 years old?
Because a Benefit Quoting Tool (BQT) response of "preauth required" does not mean services are covered, representatives must verify these separately to ensure the member has coverage.
What are benefits?
When verifying privacy, no matter how confident you may feel, you should never rely on this.
What is memory?
Because they lack a centralized nervous system, these sea creatures have no heart, brain, or blood, yet they have drifted through earth's oceans for over 500 million years.
What are jellyfish?
This is the effective date of the chiropractic reimbursement and pre-authorization policy changes.
What is October 1, 2026?
Besides being involved in a member's health care, a caller can also qualify as "involved in care" by being connected to this aspect of the member's life.
What is the payment of their health care?
To help Utah children age 18 and under maintain continuity of mental health care when leaving Utah's Division of Child and Family Services (DCFS) custody, Customer Service will assist callers with a request for this.
What is a Single Case Agreement?
According to KMT 32148 Standard Follow-up and Aging Guidelines, tasks should be updated within this timeframe.
What is three to five days?
Capable of sleeping while floating, holding hands so they don't drift apart, and storing their favorite rock in a built-in pocket under their armpit, these marine mammals take sea relaxation seriously.
What are sea otters?
This is a Plan code for North Dakota.
What is 320?
A parent's ability to sign a Disclosure Authorization for their minor child may be affected if this is on file.
What is a Confidential Communications request?