Enter Title

Controllable/ Non- controllable

100

Tone 

 Controllable 

200

Members Attitude 

Controllable 

300

Decisions 

Non-Controllable 

400

External Circumstances 

non- controllable 

500

Empathy 

 Controllable 

Systems

100

Used to create unique letters members may need (compliance letters, confirmation of enrollment letters, etc.

OBC

200

Used to view any incoming documents from members and providers

IOP

300

Used to order member forms 

Onekit 

400

Resource to confirm provider participation

SFE

500

Used for provider look ups (EPDB), finding what benefit a code may fall under (Service code Inquiry) or finding the possible cost for a benefit with a % (Rate Inquiry

RUMBA

LIS

100

What KA do you use for Low Income Subsidy (LIS) Call Handling   ?

KA 4446

200

What is Part D Low Income Subsidy (LIS)?

_{Part D Low Income Subsidy (LIS) also known as Extra Help, is a program for members who need financial help with the Medicare Part D premium costs. It can help:}

• _{Lower the monthly premium costs.}
• _{Lower or remove cost share costs, such as copays, coinsurance, or deductibles.}

300

Which level of LIS need to pay for prescriptions ? 

Level 1 and Level 2 

400

What is the RX oop amount for a LIS member with level 1 and 2 ?

$2,100 

500

What happens when a LIS member’s Rx OOP (out of pocket, also referred to as TrOOP ) is reached ? 

the member’s cost share will go down to $0 per prescription (generic or all others).

Wild card

100

Who are the two vendors that assist with  Non-Emergency Medical Transportation 

SafeRide and MTM 

200

Are case manager only for Dual members? 

NO

There may be times when members are not identified for these programs but still need our help. CSR’s can assist with identifying those members. We have established criteria that can be used to refer a member to Case Management.  (KA 2710) 

300

What is HelpingWithHeart ?

HelpingWithHeart is how we show real care to every member. It’s more than just doing tasks. It’s about making each call feel warm, helpful, and kind

400

Which state ended participation with Carelon this year?

Missouri 

500

What is the most recent campaign for members 

February 2026 Member Outreach Newsletter Campaign

Its all relative

100

Who won the Super Bowl LX

Seahawks

200

What is the 3 planet from the sun 

Earth 

300

What is Bad Bunnys real name ?

Benito Antonio Martinez Ocasio 

400

Who is the OM for Aetna (Laredo) 

Martin Sandoval 

500

how many countries in the Americas?

35 Independent countries