Knowledge Central
This Job aid will help Advocates determine how to begin each call & how to close the call
What is Greetings and Closings - Index?
This intent is used to send out fulfillment items such as an ID card or an Evidence of Coverage.
What is Member Materials?
Online database of resources that are available in the community and nationwide
What is finhelp.org(Aunt Bertha)?
Through this program, health care practitioners make in-home clinical visits with members to evaluate their health conditions. The program is designed to educate and help our members. This visit is meant to support the care the member receives from their primary care provider. It does not replace their regular PCP visits or the annual wellness exam. There is no additional cost for this program to our members.
What is HouseCalls Program?
Show me how to find a member in Maestro
What is New - Phone call - enter member Id number or first & last name DOB & hit search?
This Job aid or SOP you can use to assist a member with Completing the health assessment?
What is Complete Health Assessment in ICUE?
This intent is used to document a scheduled appointment during the call with the member.
What is Schedule Appointment?
Houses Medicaid Accounts
Capture member data such as address, eligibility, coordination of benefits, claims, and primary care physician information
What is Facets?
This is a Medicare requirement that provides the plan with health-related information about members.
What is Health Assessment?
Show me how to update a phone number
What is Add Task - Update member Profile - Update Member Contact Data & update the phone number
This index is to help locate resources while handling calls for DSNP members.
What is DSNP Advocate - Index?
This intent lets you update the permanent, mailing or temporary address
What is Update Member Address?
This system is used to complete a health assessment.
What is ICUE?
This Next Best Action assists the member in taking this preventative care by scheduling a colonoscopy or providing education regarding the iFOBT kit.
What is Colon Cancer Screening?
Show me how to see if a member had a housecall appointment scheduled
What is Housecall Member Status Lookup Tool - enter member ID & review information
These job aids provide a quick reference of Maestro Category, Intent, and Request Types for common calls.
What is Maestro Category Intent Request Type - Index?
This intent is used to locate & change a PCP for a member along with finding facilities & specialists
What is Search and Assign Provider?
View member eligibility and Medicaid provider when Medicaid isn’t with UHC
What is DMEVS?
This Next Best Action encourages women to take an active role in scheduling their breast cancer screening by scheduling the member directly with a facility.
What is Breast Cancer Screening?
Show me how to find a PCP or a specialist
What is Add task - search & assign intent - launch search provider - Rally opens & search for what you need?
The job aids within this index provide the requirements and guidance for properly authenticating the caller and protecting the privacy of our members.
What is HIPAA - Index?
This intent will provide us information regarding members benefits along with medicaid level
What is Review Medical Benefits?
This is our main system we use on a day to day basis when it comes to member information & documenting what the member is calling in about.
What is Maestro?
This is an opportunity for members to have their health assessed by their doctor and develop a plan of care that fits their needs.
What is Annual Wellness Visit?
Show me how to search for a medical benefit
What is Add task - Review medical benefits - Verify plan - view benefits & look for the benefit member is inquiring about?