The Member is dissatisfied because their ride never came. The Member checked the ride status and it showed canceled by the driver , The Member is trying to get to their doctors office for appointment
Transportation/Transportation late or no show
what is Team Payne current UES goal
1 a day or 20 per month
The Member is dissatisfied because their ride never came. The Member checked the ride status and it showed canceled by the driver , The Member was able to get a ride from a relative
Standard VG
Should you always contact the provider regarding the allegations / issue.
False
DSNP
`Dual special Needs Plan
Member called in stating he is unable to create an online account.
Customer service/ Technology
What is the name of the IVR
Avery
Member called in stating the pharmacy dispensed only 25 Oxycodone pills, Member states her prescription is for 30 day supply.
QOC
It is required to create separate intents if the grievance falls under multiple dropdowns.
TRUE
COB
Coordination of Benefits
Member called in upset that he has received another member's mail.
fulfillment/HIPAA Breach
who is eligible to become a service Hero
Program Timeline
Transportation Vendor calls member within 24 hours of the scheduled ride to advise a driver could not be located.
QOC
Is the customer service number to safe ride 866-244-2331.
False(866-244-3123.)
VBC
Value Based plan
Member called in states he always experiences delays or issue with their rewards credits
OTC, Healthy Food and Utilities/OTC, Healthy Food and Utilities
When does AEP start
October 15 thru December 7
Member went in for an appointment and was told she cannot be seen until the outstanding balance is paid.
VG
Some members with certain plans living in certain counties with ModivCare can exceed their mileage limit due to the rural nature of the area.
TRUE
MIOD
Member initiated organization determination
Member called in stating they received a bill from a provider they never saw or received services from.
Provider / Facility / Hospital /Fraud Allegation
When can we begin to discuss 2025 plan options
October 1st
Member called in upset that she was not able to enroll into a aqua aerobics class that her Doctor recommended for her back pain.
VG
If an appointment is available within the Access to Care timeframe, it is not a QOC.
True
PPO
Preferred provider organization