Investigation Process
Order Related
Financial Requests
100

This step involves gathering information and evidence related to a grievance.

What is an investigation?

100

This department is responsible for deciding whether a member qualifies for a new shipment of meals.


What is MCO?)

100

This request involves transferring funds from one expired wallet to another active one.

What is a rollover request?

200

This final step in the grievance process involves reaching an agreement or solution.

What is resolution?

200

This technique involves placing an order for a member that does not appear in the order history.

What is a manual order?

200

This type of check is issued to repay an employee for expenses they have incurred.

What is a reimbursement check?

300

This term refers to the maximum amount of time allowed to resolve a grievance.

What is the SLA timeframe?

300

This term describes an order placed for a member that does not appear in the system’s order history.

What is a Ghost Order?

300

This is the maximum period a BCBSRI member has to submit a reimbursement request.

What is a year?

400

This software is used to monitor and manage all received grievances and their resolutions.

What is Zendesk?

400

This term refers to the return of money to a customer for a product or service that was unsatisfactory or not delivered.

What is a refund?

400

This term refers to a temporary hold placed on funds to ensure payment for a future transaction.

What is a pre-authorization hold?

500

This role is responsible for managing and resolving grievances within an organization.

Who is a grievance Specialist?

500

This term describes a shipment that is guaranteed to be delivered by the next day.

What is an overnight package?

500

 This internal process With NationsBenefits IT team to recover expired flex funds 

What is the Elevance rollover process?

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