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.
Which tool should CSS use daily to determine the steps to complete something?
What is OneNote.
How does a CSS sign 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?
Which tool must be used to locate an EOC or a Commercial members document not reflected in Pega?
What is Corporate Applications?
What is required always when 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
What two operational call centers are there at HAP?
What is Member Services and Provider Inquiry
Who is HAP's overflow customer service vendor?
Sagility
Which intent should be used when a member wants to change their communication preferences?
What is Update Member Profile.
Which tool should be used to check if a procedure code requires a prior authorization?
What is the Procedure Reference List (PRL)?
How does CSS properly close out of an authorization, grievance or appeal?
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.
Who are the managers of Customer Service?
Who is Kristen Pore' and Elaina Ferguson
What should be done in Pega when a caller is part of an employer group and supposed to already be active, however is not showing up in Pega?
What is document an Unaffiliated Caller intent and launch a GSR to route to M&B.
Which 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?
What is required to do to ensure CSS sees 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.
Which intent and service item should be launched to document when a member is having trouble getting in to see her cardiologist?
What is the General Service request / Access / Specialty care.
What is the tool to use if you are checking for missing preventative services a member has?
What is HEDIS gap search.
What vendor handles authorization requests for musculoskeletal and cardiac procedures?
What 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.
Who is the Vice President of Consumer Operations?
Who is Heather Spencer.
This department at HAP handles eligibility concerns among many other things.
What 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.
Which document in OneNote does CS leadership hold staff accountable to, outside of DLP's? This document has been known before as the "bible of CS".
What is the Call Handling Procedure?
This service always requires an authorization.
What are inpatient services.
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.
What are the hours of operation for the Government and Commercial Customer Service department from October 1 through March 31st?
What is 7 days a week from 8a-8p for Government and 5 days a week from 8a-6p.
This intent is launched, with this service item type, and routed when a member has a COB issue he/she wants escalated.
What is GSR / COB / COB Escalation
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.
Premium invoices can be found where in Pega?
What is the documents tab.