Communications
On which screen in CRM are you able to view VAT calls and Letter sent to the member?
RTI Communications
Which quick link is used to check status and send ID cards?
ID Card Management
Which option is selected in Demographic Update Template to update Name, Gender and D.O.B ?
Critical Demographic Update
What is a grievance?
When the member expresses dissatisfaction about something other than the way that a claim or a medical or pharmacy authorization processed.
What were the names of the 2 Rats in YoTV land?
Gundi no Mazwi
What does VAT stand for and what is the voice prompt called when a VAT call is transferred to an advocate?
Whisper Tone
What is the C&I for a member requesting to be sent materials?
Classification: Fulfillment
Intent: Letter/Form Request
What is the C&I for an unsuccessful Demographics Update?
Classification: Demographics
Intent: No change
60 Days
Which planet in our solar system is known as the "Red Planet"?
Mars
How often does a member receive a SmartSummary?
Every month when a claim has been processed in the previous month.
Name the 2 applications that are used to send member requested materials.
EMME and OMS
Why would a temp address update be performed and which benefit is the member required to have for this change?
Member is moving from the Service Area.
They need to have the travel benefit.
What are the three ways a grievance can be submitted?
Verbal, Written, Online
What is the capital city of Australia?
Canberra
What is the C&I for a member who receives a SmartSummary?
Classification: Communication
Intent: SmartSummary
What are the plan identifying numbers called used to search the OMS Index?
Format: H0028 007 000
Contract, PBP, Segment
Which site is used to verify CMS changes?
What is the process flow to advise members on changes to their Name, D.O.B and Gender?
Wipro
Inform SSA>SSA informs CMS>CMS informs Humana
What does the QAA abbreviation stand for?
What is the definition of a QAA Complaint?
Quality, Attitude, Access to Care
•A QAA complaint is a member’s expression of concern regarding the quality of care received, the attitude of the provider, or a lack of access to desired or needed medical services.
What is the only metallic element that is liquid at standard room temperature and pressure?
Mercury
In the RTI communications window, which icons allow you to view and resend a letter?
The "eye" and the "send triangle"
What is the TAT for an ID card to be received?
What is the TAT for a letter to be receieved?
Business or calendar days
ID Card- 5-7 Calendar Days
Letter: 7-14 Business Days
Where do you access the Update Plan Demographics Template?
In the Case Edit Page
Who can file a grievance?
Member, POA and AOR(Appointment of Representation.
In what year did the RMS Titanic sink in the North Atlantic Ocean after hitting an iceberg?
1912