HAP
Who is the director of Customer Service?
Venus Pope
What is the required greeting for HAP Customer Service Specialists?
What is "Thank you for calling HAP Customer Service Department, my name is ____, how can I make your day better?"
What intent and category should be used to document HEDIS gaps?
What is the GSR / other.
This tool is used daily to locate a DLP.
What is OneNote?
This is how a CSS signs into CareRadius?
What is the network username without hap.org and the network password?
CS must always do this before capturing financial information.
What is pause the recording in Genesys.
Which two cities does HAP have a lobby in?
What is Troy and Detroit
What is required for CS to close a call?
What is to ask the caller if there are any other questions or benefit questions.
How would a call be documented if the caller cannot be found in Pega?
What is Unaffiliated Caller?
This is where a CSS goes to locate an EOC or commercial source documents when not reflected in Pega.
What is Corporate Applications?
This is required once a CSS is finished looking at a member in CareRadius.
What is x out of tab that contains member name in the web browser.
This number must be copied from Pega and used to locate the member on the payment portal.
What is the AR account ID
These two departments are the operational call centers for HAP.
What is Member Services and Provider Inquiry?
This company is HAP's overflow customer service vendor.
Who is Sagility?
This intent is used when a member wants to change their cell number for text messaging.
What is Update Member Profile?
This tool should be used to check if a procedure code requires a prior authorization.
What is the Procedure Reference List (PRL)?
To properly close out of an authorization, grievance or appeal in CareRadius, the CSS must do this.
What is selecting close in the grey bar to unlock the account for others?
This DLP would be used for assistance with handling a premium payment.
What is DLP.CS.056 Payment Processing?
HAP partners with this company to provide dental coverage.
Who is Delta Dental?
These individuals are the managers of Customer Service.
Who is Kristen Pore' and Elaina Ferguson?
When a caller is part of an employer group and supposed to already be active, however is not showing up in Pega, CSS should do this.
What is document an Unaffiliated Caller intent and launch a GSR to route to M&B?
This tool should be used to determine if there is certain criteria required to be met for a specific service?
What is the Benefit Administration Manual?
CSS must do this to ensure he/she can see all authorizations, appeals and grievances for a member.
What is remove the filter date and select apply filter?
These members will not have any premium information in Pega.
What are employer group members?
This entity is the parent company of HAP.
What is Henry Ford Health System.
As a CSS, its always important to do this when away from his/her desk and unable to take a call.
What is change to the correct status in Genesys?
This intent and service item types is launched to document information provided to a caller about a specialist.
What is the General Service request / Access / Specialty care?
This tool is used to check for missing preventative services for a member.
What is HEDIS gap search?
This vendor handles authorization requests for musculoskeletal and cardiac procedures.
Who is Turning Point?
Members can pay their premium one of these four ways.
What is by mail, in the lobby, over the phone or online.
This individual is the Vice President of Consumer Operations?
Who is Heather Spencer?
This department handles eligibility concerns among many other things.
Who is Membership and Billing?
This intent is launched when a member calls to determine his/her accumulations from a previous year.
What is Member Eligibility and Benefits intent?
This document will help a Government CSS determine if an FEHB member has a standard or high plan with HAP.
What is the current year FEHB brochure?
This service always requires an authorization.
What is inpatient care?
Invoices are generated this day of every month.
What is the 5th.
HAP has two initiatives that would like addressed on calls, what are they?
What are Communication Preferences and HEDIS gaps.
This is the main government phone number.
What is 800-801-1770?
The caller needs to change PCP, has a question about a Specialist, has HEDIS gaps, needs communication preferences updated and needs benefits for OT. The CSS must document the following intents.
What is GSR / Access / Specialty?
What is GSR /Other?
What is Update Member Profile?
What is Update/Add/Chane PCP?
What is Member Eligibility and Benefits?
This resource is used when a member needs her password reset.
What is the Security Admin tool?
CS launches a Eligibility and Benefit intent and routes it to the Referral Management team (RMT) for this reason.
What is to initiate a member authorization request?
If the day is the 25th of the month and a caller wants to set up AWD, CSS should...........
What is take that months premium over the phone and set up AWD for the next months premium?