Education
KA: https://service360.lightning.force.com/lightning/r/Knowledge__kav/ka7Dn000000Kyt1IAC/view
ESA education
Deduct/MOOP status
Accumulator review
Ben Review
A member as called to get information on how to submit for eyewear reimbursement after getting cataract surgery. What is the correct information to provide to the member?
KA: https://service360.lightning.force.com/lightning/r/Knowledge__kav/ka75b000000wkTFAAY/view
KA: https://service360.lightning.force.com/lightning/r/Knowledge__kav/ka7Dn000000Kyt1IAC/view
Educate on claim reimbursement process.
Dead Air Example:
Call Date: 1/10
Verint ID: 9150577300480006851
Roundtable best practice
An SERS member has called in to get an understanding on their OTC benefit as they went Walmart to pick up OTC items and were told they don't have coverage. What should be educated to the member?
The member has called because they were told they had to get hearing aids through Nations Hearing but they thought they could order from anywhere. What is the correct information to provide to the member?
KA: https://service360.lightning.force.com/lightning/r/Knowledge__kav/ka7Dn000000TN6UIAW/view
KA:
https://service360.lightning.force.com/lightning/r/Knowledge__kav/ka7Dn000000Kyt1IAC/view
KA: https://service360.lightning.force.com/lightning/r/Knowledge__kav/ka7Dn000000KytQIAS/view
Benefit/Accumulator review
Hold Example:
Date of Call: 1/11
Verint ID: 9150586597950006851
KA: https://service360.lightning.force.com/lightning/r/Knowledge__kav/ka75b0000004HRRAA2/view
Round table best practices.
The member has called in to get a list of participating providers as they are new to MAPD coverage with a PPO policy and want to see if their providers are in-network. What actions should you take to ensure full and proper education?
KA: https://service360.lightning.force.com/lightning/r/Knowledge__kav/ka7Dn00000000J8IAI/view
Deduct/MOOP review
INN/OON Benefit review
OON Provider requirements
A member would like to order an ID card as theirs was lost, once ordering the ID card what is the correct turnaround time?
Delayed Greeting Example
Date of Call: 1/5
Verint ID: 9150532886390006851
Round table best practice