NGD/Scripting
The Marketplace has done research on what makes a CSR successful. Which actions will help you perform as a successful CSR more quickly?
Be familiar with your resources so you know where to turn when you have questions. AND
Leave notes to summarize the call in case the consumer calls back later.
What are two key benefits of the Affordable Care Act (ACA)?
Consumers have the right to appeal a health insurance company’s denial of coverage. and
People with pre-existing conditions cannot be charged more for coverage.
TRUE OR FALSE
The name of a consumer’s doctor is part of their protected health information (PHI), which a CSR must protect.
FALSE
What should a CSR do next after reading the Welcome Consumers and Direct Calls script?
Actively listen to the consumer, ask probing questions, and confirm the needs of the consumer.
What step, assess Needs in the Marketplace Call Flow?
Step 2
The ____________ and its different views allow you to access almost all of the information you need to assist a consumer. You can navigate to those views via the view bar.
FFM Contacts screen
The ___________ is the amount a consumer or employer pays for a health insurance plan.
Premium
TRUE or FALSE
A CSR’s role is to protect and ensure the security of personally identifiable information (PII), which is a type of information that can be used to distinguish or trace a consumer’s identity (e.g., consumer’s full name, Social Security number, birth date, or address).
TRUE
What is the next thing a CSR should do after a consumer passes disclosure?
Check for and read any unread consumer messages to the consumer.
What is the next thing a CSR should do after a consumer passes disclosure?
Check for and read any unread consumer messages to the consumer.
The My Current Feedback list applet and the User Alerts list applet both appear on the......
Home screen
Tammie owns Rottweilers. How many?
5
Personally identifiable information (PII) and protected health information (PHI) may be used and disclosed when?
The extent necessary to carry out Marketplace-required functions. AND
Only if the consumer or authorized representative successfully passes disclosure*
You receive a call from a consumer. After thoroughly searching with her Social Security number and last name, you discover that the consumer doesn’t have a HealthCare.gov account, but she has previously called the Marketplace for plan information. Where is the record located?
NGD Contacts list applet
The purpose of paraphrasing after actively listening to a consumer is to.....
Show that you understand them by taking their information and summarizing it in your own words.
Scripts directly affect the consumer in the following way.....
All consumers receive the same, consistent information. and
Receiving accurate information about the Marketplace helps establish trust between the CSR and the consumer.
If a consumer would like to pay less for monthly premiums and is comfortable with higher out-of-pocket costs, a __________ might best fit their needs.
Bronze or silver plan
You should encourage consumers to do the following to protect themselves against fraud and scams:
Look for the logos of the Department of Health & Human Services and the Health Insurance Marketplace. AND
Be aware of promotions that seem too good to be true.
When you are locating a consumer record by using the Consumer/Contact Search form applet, a more targeted search will result from entering more criteria. In addition to the consumer’s name, you can use the contact search filters to look for the record by their:
Social Security number (SSN) or birth date
The purpose of asking probing questions after actively listening to a consumer is to.....
Make sure you have all the information needed for identifying the correct resolution.
It is important to log every script you use to help a consumer because.....
CMS can identify which scripts CSRs are accessing and using, which impacts script updates. and
CMS can better understand the topics CSRs are addressing, which helps with continuous training improvements.*
TRUE OR FALSE
All Marketplace plans offer a comprehensive package of items and services known as essential health benefits (EHB). Health insurance companies can set a yearly and a lifetime dollar limit on spending for EHB services.
FALSE
High-quality customer service in the Marketplace includes
Speaking in a conversational manner, sounding professional and engaged and
Providing accurate and complete information*
To have a consumer pass disclosure, you must verify 3 pieces of identifying information and certify the verification in NGD. In addition to full name, what 2 additional pieces of identifying information are acceptable?
Full address and application ID number*
what is the language line?
A service available for consumers who do not speak English or Spanish, or who need translation assistance.