MEC Basics
What does MECS stand for?
Member Enrollment & Clinical Services
What tool is commonly used to check evaluator availability?
2.0
What is the first step of a standard call script?
Verify the member using authentication questions
HIPAA protects what type of information?
PHI (Protected Health Information)
When do you escalate a call to a supervisor?
Member distress, complaints, safety issues, system errors
MECS supports which functional area of Signify Health?
In-home evaluations / clinical operations
What should you verify BEFORE offering an appointment?
Member eligibility DOB & location
What's one best practice for building rapport with members?
Empathy statements, clear tone, speaking slowly, etc.
True or False: It's okay to leave PHI on a voicemail.
False
What should you do if the member reports they already completed a visit?
Check records, update disposition
Name one core responsibility of a MECS agent.
Scheduling, eligibility review, member outreach, data verification, etc.
When a member declines, what must you complete in the system?
Dispositioning the call accurately
How should agents respond if a member is confused about the service cost?
Explain: “This is a no-cost health visit through your plan…”
What are the two key pieces of data verified to confirm member identity?
Name & DOB (or plan-required combo)
A member wants to cancel but asks for “future contact only.” What is required?
Update outreach preferences
True or False: MECS agents can make clinical decisions.
False
A member asks for a different evaluator. What’s the correct next step?
Check availability & reschedule per guidelines
What should you NEVER do when speaking with a member?
Give medical advice
What should you do if data in the system doesn’t match the member’s statements?
Document & follow correction protocol
If a member reports fraud, who do you notify?
Compliance or designated internal contact (sup) Slack
What is the primary goal of MECS?
Support safe, accurate, efficient care coordination for members
Name two red flags that require escalating before scheduling.
Safety issues, clinical questions, wrong member, severe distress, etc.
If a member expresses safety concerns, what must you do?
Document, escalate, and follow safety protocol
Name one example of PHI you must secure.
Address, DOB, health data, plan ID, etc.
A member says the provider never arrived—what do you do first?
Verify appointment time and submit a slack