Call Miner
What must be said on EVERY call regardless of disposition?
FCC Statement/ Recorded call Disclosure
Completed a FULL screen and it was an accept
Accepted case
We must confirm the blank and blank of both the member and person we are communicating with or it’s an Auto-Fail.
First and last name
When unsure what to do on an account what should you do?
Check the notes on the account, look in resources guide and after completing all of those and are still un sure then ask for help
We should be noting all cases we assist with. The case note must specifically state whether the case is being blank or blank
Accepted or Self-Directed
What phrase is said for PHI for Call Miner to count it?
"Can you please verify your Date of Birth, complete mailing address and phone number?”
• Dead Air/ no Answer
• Call back requested before PHI verification
• Call Disconnected before PHI verification
Call Attempted
What is the max age we will screen?
62 years old
What is the break allowance per a 4 hour working shift?
15 minutes.
What needs to match on the Screening guide and the SSI application?
Treating source and medication quantity.
What category do these quotes belong to?
“Let me help you with…”
“Let me make sure…”
“Let me look and see…”
“We are here to help”
“What I can do is…”
Ownership
• Screened, closed and consultative talking points given
• Member is not interested in our serviced at this time
• Agreed to our consultative talking points (60-90day call back)
Closed consultative
What should all bilingual/translation calls be logged as in LiveVox? Regardless of accepted or self-directed.
Transferred
When we clock into Dayforce, we must be logged into our LiveVox phone system no later than...?
2 minutes. Your phone hours should match your timesheet.
When a member is not a citizen where can we look to see if we can assist?
Non-Citizenship and SSI Tab in the SOS resource guide
Which category doe these quotes belong to?
“Thanks so much for that information/for taking the time to speak with me”
Referring to claimant as “Sir/Ma’am”
“Is there anything else I can help with?”
“Have a great/good/wonderful/blessed day!”
Politeness
• Call back requested after PHI verification or during screening
• Call drops/disconnected on either side after PHI verification
• In progress cases
Incomplete Screen
For children cases, who's income is not counted?
Grandparents, legal guardians.
If we do not provide consultative talking points to the member, we must change the close reason to?
Refuse consultative.
What must be added to the application tab when a case is accepted or self-directed.
The screening guide score.
Which 2 categories require 2 different quotes for it to count?
Politeness and Ownership
• Wrong Number
• Member is deceased
• Refused Consultative- did not approve of 60-90 day call back
• Unable to provide consultative talking points
Do Not Call
What 2 things must we verify to determine if we can start an appeal?
Appeal priority.
Was is a medical or technical denial?
What are the 4 minimum requirements that SOS must fulfill before being eligible to bonus?
4.00 Accept Average, 92% Quality Audit, 75% Good Decision, 90% attendance
List 3 main doc types we must save to Documents after submitting an application.
Re-entry, Summary, Receipt, Overview, Confirmation page